title: Abciximab improves 6-month clinical outcome after rescue coronary angioplasty.
abstract: BACKGROUND
  Few data are available concerning the effects on clinical outcome and left ventricular function of abciximab administration in patients undergoing rescue percutaneous transluminal coronary angioplasty (PTCA) after failed thrombolysis for acute myocardial infarction. The aim of the study was to investigate such effects.
  
  
  METHODS
  Eighty-nine consecutive patients referred to our laboratory from other hospitals for rescue PTCA within 24 hours from the onset of chest pain were prospectively randomized before the procedure to abciximab treatment (44 patients) or placebo (45 patients). No significant differences in baseline characteristics were observed between the 2 groups. Study end points were the occurrence of major adverse cardiac events (MACE) such as death, reinfarction, congestive heart failure, target lesion revascularization, or recurrent ischemia at 30-day and 6-month follow-up and the occurrence of periprocedural bleeding.
  
  
  RESULTS
  Mean time from symptom onset to reperfusion was 8.5 +/-5.4 hours; rescue PTCA was successful in 96% of patients. The incidence of major, moderate, and minor bleeding was similar in the 2 groups. At 30-day follow-up, the echocardiographic left ventricular wall motion score index showed a significantly higher improvement in the abciximab group versus the placebo group (P <.001). At 6-month follow-up, the incidence of MACE was 11% in the abciximab group versus 38% in the placebo group (P =.004). Abciximab administration (P =.003) and cardiogenic shock (P =.005) were the only independent predictors of the occurrence of MACE at multivariable analysis.
  
  
  CONCLUSIONS
  Treatment with abciximab during rescue PTCA positively affects clinical outcome at 6-month follow-up without increasing periprocedural bleeding.
authors.affiliation: Cardiothoracic Department, University of Pisa, Ospedale Cisanello, Pisa, Italy. a.petronio@mail.ao-pisa.toscana.it
authors.forename: Anna Sonia
authors.initials: AS
authors.lastname: Petronio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
authors.forename: Ugo
authors.initials: U
authors.lastname: Limbruno
authors.forename: Marco
authors.initials: M
authors.lastname: De Carlo
authors.forename: Roberto
authors.initials: R
authors.lastname: Baglini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paterni
authors.forename: Maria
authors.initials: M
authors.lastname: Grazia Delle Donne
authors.forename: Paolo
authors.initials: P
authors.lastname: Caravelli
authors.forename: Carmela
authors.initials: C
authors.lastname: Nardi
authors.forename: Mario
authors.initials: M
authors.lastname: Mariani
mesh_terms: D000077284:Abciximab; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D011446:Prospective Studies; D016879:Salvage Therapy; D017211:Treatment Failure; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077284:Abciximab