The clinical results of a platelet glycoprotein IIb/IIIa receptor blocker (abciximab: ReoPro)-coated stent in acute myocardial infarction.
OBJECTIVE
This study is a prospective randomized trial investigating clinical outcomes of patients with acute myocardial infarction (AMI) treated with abciximab (ReoPro)-coated stents.


BACKGROUND
Recently we have demonstrated that abciximab-coated stents have inhibitory effects in the prevention of coronary restenosis.


METHODS
Ninety-six patients with AMI were randomly allocated into two groups; group I received abciximab-coated stents (n = 48, 57.1 +/- 12.0 years), and group II received bare metal control stents (n = 48, 58.4 +/- 11.6 years).


RESULTS
At baseline, clinical characteristics, percent diameter stenosis, and minimal luminal diameter were no different between the two groups. One patient in group II had reinfarction and target lesion reintervention during hospital stay. Follow-up coronary angiography was obtained in 77.1% (37 of 48) in group I and 75.0% (36 of 48) in group II. Percent diameter stenosis and late loss were significantly lower in group I than group II (18.9 +/- 5.54% vs. 37.9 +/- 6.25%, p = 0.008; and 0.39 +/- 0.29 mm vs. 0.88 +/- 0.45 mm; p = 0.008, respectively). At follow-up intravascular ultrasound, intrastent lumen area and intrastent neointimal hyperplasia (NIH) area were 5.4 +/- 1.8 mm2 and 2.2 +/- 1.5 mm2, respectively, in group I and 4.3 +/- 1.6 mm2 and 3.4 +/- 1.8 mm2, respectively, in group II (p = 0.045). And, in-stent restenosis rate was lower in group I than group II (p = 0.011 and p = 0.008, respectively). During 1-year follow-up, two patients in group II (4.1%) had AMI, whereas no patient in group I suffered AMI. Target lesion revascularization and total major adverse cardiac events rates were relatively lower in group I compared with those in group II (10.4% [5 of 48] vs. 20.8% [10 of 48], p = 0.261, and 10.4% vs. 25.0%, p = 0.107, respectively).


CONCLUSIONS
Abciximab-coated stent implantation was safe and effective without stent thrombosis in AMI patients.
Kim
Weon
W
Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Jeong
Myung Ho
MH
Kim
Kye Hun
KH
Sohn
Il Suk
IS
Hong
Young Joon
YJ
Park
Hyung Wook
HW
Kim
Ju Han
JH
Ahn
Young Keun
YK
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Cho
Dong Lyun
DL
Kang
Jung Chae
JC
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000517:prevention & control; D004337:Drug Carriers; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011446:Prospective Studies; D015607:Stents
D000911:Antibodies, Monoclonal; D004337:Drug Carriers; D007140:Immunoglobulin Fab Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077284:Abciximab