Angiographic evaluation of the effect of intracoronary abciximab administration in patients undergoing urgent PCI.
BACKGROUND
Recent data suggest that the intracoronary (i.c.) administration of a systemic bolus dose of abciximab during PCI may increase the efficacy of this antiplatelet drug. However, the effect of i.c. abciximab on coronary angiographic flow has been not clarified.


METHODS
We studied 37 consecutive patients with acute coronary syndromes (ACS) who underwent successful urgent PCI on the target vessel and were treated by an i.c. abciximab bolus (0.25 mg/kg) prior to the first balloon inflation (Group IC), and 37 matched controls who were treated by intravenous (i.v.) abciximab bolus at the same dose (Group IV). Corrected TIMI frame count (CTFC) in the culprit and in a non-culprit coronary artery branch was assessed before treatment, immediately after intracoronary administration of abciximab bolus and at the end of the procedure.


RESULTS
After administration of abciximab, CTFC significantly decreased from 48+37 to 33+30 (P=0.001) in the culprit vessel while in the non-culprit vessel it remained unchanged (16+7 pre-treatment and 16+7 post-treatment, P=0.68). Final CTFC was 12+4 in Group IC and 14+5 in Group IV (P=0.069). Post-treatment mean peak of the cardiac enzymes showed a trend toward reduction in Group IC compared with Group IV.


CONCLUSIONS
The i.c. administration of abciximab bolus acutely decreases CTFC through culprit vessels of patients with ACS undergoing urgent PCI. Further studies evaluating the potential clinical benefits associated with i.c. abciximab administration are warranted.
Romagnoli
Enrico
E
Institute of Cardiology, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy. enromagnolimd@hotmail.com
Burzotta
Francesco
F
Trani
Carlo
C
Mazzari
Mario A
MA
Biondi-Zoccai
Giuseppe G L
GG
De Vita
Maria
M
Giannico
Floriana
F
Niccoli
Giampaolo
G
Prati
Francesco
F
Rebuzzi
Antonio G
AG
Mongiardo
Rocco
R
Crea
Filippo
F
D000077284:Abciximab; D000789:Angina, Unstable / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000494:pharmacology; D000925:Anticoagulants / Q000008:administration & dosage* / Q000494:pharmacology; D017023:Coronary Angiography / Q000187:drug effects*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage* / Q000494:pharmacology; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D011446:Prospective Studies
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab