Restoration of coronary blood flow by single bolus injection of the GPIIb/IIIa receptor antagonist c7E3 Fab in a patient with acute myocardial infarction of recent onset.
It has been debated that primary coronary angioplasty could be more effective if immediate antithrombotic therapy would contribute to a faster recanalization of the infarct-related artery. This is the first report of a patient who presented at the emergency department with acute anterolateral myocardial infarction, in whom a single bolus injection of c7E3 Fab (0.25 mg/kg body weight) led to complete reperfusion of the infarct-related coronary artery during organization time for planned acute coronary angioplasty. Pain relief 15 min after initiation of therapy and ST-segment resolution of > 50%, as well as occurrence of idioventricular rhythm 30 min thereafter, were suggestive of successful recanalization before the coronary intervention was started. Diagnostic coronary angiography at 90 min revealed TIMI-grade 3 flow in the infarct-related coronary artery with only moderate luminal irregularities. Bolus administration of c7E3 Fab could be effective for dissolving platelet-rich thrombi in the early stage of acute myocardial infarction (AMI) and may therefore represent a promising "bridging" therapy in patients with AMI elected for primary coronary angioplasty.
Domanovits
H
H
Department of Emergency Medicine, University of Vienna, Austria.
Nikfardjam
M
M
Janata
K
K
Hornykewycz
S
S
Maurer
G
G
Laggner
A N
AN
Huber
K
K
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000503:physiopathology*; D004562:Electrocardiography / Q000187:drug effects; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D012039:Regional Blood Flow / Q000187:drug effects
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077284:Abciximab