title: Safety of abciximab administration during PCI of patients with previous stroke.
abstract: OBJECTIVE
  To examine the frequency of cerebrovascular complications among patients receiving abciximab (AB) undergoing PCI with prior intracranial hemorrhage (ICH) or recent (< 2 years) ischemic strokes.
  
  
  BACKGROUND
  AB improves clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI); however, the safety of AB in patients with prior stroke has not been adequately studied.
  
  
  METHODS
  A database review of 7,244 consecutive PCIs, from 7/97 to 10/01, identified 6,190 PCIs performed with AB among which 515 interventions were performed in patients with prior stroke history [ICH or recent ischemic stroke, (n = 101) and remote (> 2 years) ischemic stroke, (n = 414)].
  
  
  RESULTS
  The post-PCI stroke rate was significantly higher in patients with prior stroke (2.06% vs. 0.35%, p < 0.001 for all stroke; 0.38% vs. 0.03%, p = 0.023 for ICH). The incidence of ICH among the AB-treated group was 0.065%; a history of prior stroke did not increase the incidence of ICH in the AB-treated group (0.39% vs. 0.0%, p = ns). Moreover, the post-PCI stroke rate was similar between the prior ICH or recent ischemic stroke-group and remote ischemic stroke-group (2 vs. 1.9%; OR: 1.03; 95% CI: 0.21-4.90; p = ns for all strokes; 2% vs. 1.5%; OR: 1.4; 95% CI: 0.27-6.91; p = ns for ischemic stroke). Importantly, no ICH occurred in patients with recent ischemic or any prior ICH stroke.
  
  
  CONCLUSIONS
  Abciximab, in addition to aspirin, heparin and ADP-inhibitors does not increase the risk of stroke in patients with prior stroke undergoing PCI.
authors.affiliation: Cardiology Section, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1045, USA.
authors.forename: Efthymios N
authors.initials: EN
authors.lastname: Deliargyris
authors.forename: Bharathi
authors.initials: B
authors.lastname: Upadhya
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Applegate
authors.forename: Jimmy L
authors.initials: JL
authors.lastname: Kontos
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kutcher
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Riesmeyer
authors.forename: David C
authors.initials: DC
authors.lastname: Sane
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D000925:Anticoagulants / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage* / Q000009:adverse effects; D015994:Incidence; D020300:Intracranial Hemorrhages; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000139:chemically induced* / Q000150:complications
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab