Rescue use of abciximab improves regional left ventricular function after early incomplete reperfusion in acute myocardial infarction.
BACKGROUND
Abciximab was shown to have important beneficial effects beyond the maintenance of epicardial coronary artery patency. However, it remains uncertain whether abciximab may lead to a better functional outcome in patients with acute myocardial infarction (AMI) and with incomplete reperfusion after primary angioplasty (PA).


OBJECTIVE
The study aimed to evaluate whether rescue use of abciximab may lead to a better functional outcome in such patients.


METHODS
The study included 25 patients with first AMI who met the following criteria: (1) total occlusion of the infarct-related artery, (2) PA within 12 h of symptom onset, (3) postprocedural diameter stenosis < 30%, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade 2. Echocardiographic examination was performed before and on Days 7 and 30 after PA. The study population was divided into two groups: Group 1 (usual care, n = 13) and Group 2 (rescue use of abciximab, n = 12). Baseline characteristics were similar between the two groups.


RESULTS
Peak level of creatine kinase was higher in Group 1 than in Group 2 (5,800+/-2,700 vs. 3,800+/-2,000 U/I, p < 0.05). At 1 month follow-up, infarct zone wall motion score index (2.71+/-0.26 vs. 2.05+/-0.63, p < 0.01) and left ventricular (LV) volume indices were smaller in Group 2 than in Group 1, whereas LV ejection fraction was higher in Group 2 than in Group 1 (52.1+/-7.8 vs. 42.1+/-6.4, p < 0.01). At 1-month, abciximab was the only independent predictor of wall motion recovery index by multiple regression analysis.


CONCLUSIONS
Rescue use of abciximab may reduce the infarct size in patients with AMI and TIMI grade 2 flow after PA, which may improve the recovery of regional LV function.
Cho
G Y
GY
Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
Lee
C W
CW
Hong
M K
MK
Kang
D H
DH
Song
J K
JK
Kim
J J
JJ
Park
S W
SW
Park
S J
SJ
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use*; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000494:pharmacology / Q000627:therapeutic use*; D012044:Regression Analysis; D017211:Treatment Failure; D016277:Ventricular Function, Left / Q000187:drug effects*
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D003402:Creatine Kinase; D000077284:Abciximab