title: Reduction in periprocedural enzyme elevation by abciximab after rotational atherectomy of type B2 lesions: Results of the Rota ReoPro randomized trial.
abstract: BACKGROUND
  Abciximab has been shown to reduce ischemic complications and creatine kinase-myocardial band (CK-MB) elevation of both simple and complex coronary interventions. In addition to the procedural complications, one of the important mechanisms for CK-MB elevation after rotational atherectomy is an interaction between platelets and the atheromatous debris.
  
  
  METHODS
  This study was conducted to determine whether abciximab would limit the extent of periprocedural CK-MB release after rotational atherectomy of American Heart Association/American College of Cardiology type B(2) lesions in a double-blind, randomized, placebo-controlled manner. A total of 100 lesions in 100 patients were randomized with the primary end point being a CK-MB elevation of >16 U/L.
  
  
  RESULTS
  Procedural success was achieved in 100% in the abciximab arm compared with 98% in the placebo group with any CK-MB elevation >16 U/L of 8% in the abciximab versus 22% in the placebo group (P =.04). The peak creatine phosphokinase level (units per liter) was 102 +/- 14 versus 153 +/- 22 (P =.05) and the peak CK-MB level was 12.8 +/- 1.8 versus 24.6 +/- 3.5 (P =.06) between the abciximab and placebo groups, respectively. Slow-flow or postprocedure chest pain occurred in 14% in the abciximab group versus 30% in the placebo group (P =.04). There was 1 Q-wave myocardial infarction in the placebo arm and 1 nonhemorrhagic stroke in the abciximab group.
  
  
  CONCLUSIONS
  Therefore the Rota ReoPro randomized trial revealed the benefit of abciximab during rotational atherectomy in reducing procedural morbidity and CK-MB elevation, and its routine use can be justified even in moderately complex lesions undergoing rotational atherectomy.
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Mt Sinai Hospital, New York, NY 10029, USA.
authors.forename: A
authors.initials: A
authors.lastname: Kini
authors.forename: D
authors.initials: D
authors.lastname: Reich
authors.forename: J D
authors.initials: JD
authors.lastname: Marmur
authors.forename: C A
authors.initials: CA
authors.lastname: Mitre
authors.forename: S K
authors.initials: SK
authors.lastname: Sharma
mesh_terms: D000077284:Abciximab; D000368:Aged; D000704:Analysis of Variance; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017225:Atherectomy, Coronary; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000145:classification / Q000201:enzymology* / Q000628:therapy*; D003402:Creatine Kinase / Q000187:drug effects* / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000201:enzymology; D011184:Postoperative Period; D015607:Stents
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D006493:Heparin; D003402:Creatine Kinase; D000077284:Abciximab