title: Early abciximab administration before primary percutaneous coronary intervention improves infarct-related artery patency and left ventricular function in high-risk patients with anterior wall myocardial infarction: a randomized study.
abstract: BACKGROUND
  Early abciximab administration before primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) is recommended in practice guidelines. However, the evidence supporting abciximab use before and during transfer for PPCI is limited. We investigated the effect of early abciximab administration on early reperfusion, ST-segment resolution, enzymatic infarct size, and left ventricular function in patients with first anterior wall STEMI.
  
  
  METHODS
  A total of 59 nonshock patients with STEMI admitted <12 hours to remote hospitals with anticipated delay to PPCI of <90 minutes were randomly assigned to 2 study groups: 27 patients received abciximab before transfer to catheterization laboratory (Early group), and 32 patients received abciximab immediately before PPCI (Late group).
  
  
  RESULTS
  Angiography revealed more frequent infarct-related artery patency in the Early group than in the Late group (TIMI 2 + 3: 48% vs 20%, P = .04). Better ST-segment resolution of >50% 60 minutes after PPCI was found in Early group than in the Late group (84% vs 56.7%, P = .04). The area under the curve for creatine kinase-MB indicated a significantly greater extent of myocardial injury in the Late group versus the Early group (8324 +/- 4185 vs 5938 +/- 3949 U/L . h, P = .04). There was a significant difference in the 30-day left ventricular end-systolic volume index (P = .02) and end-diastolic volume index (P = .05) in the echocardiography favoring the Early group.
  
  
  CONCLUSIONS
  Early abciximab administration before transfer for PPCI in patients with first anterior wall STEMI results in more frequent infarct-related artery patency before PPCI, better myocardial tissue perfusion after PPCI, with lower enzymatic infarct size and lower degree of left ventricular remodeling during 30-day follow-up.
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Zalewski
authors.forename: Jacek
authors.initials: J
authors.lastname: Legutko
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Bartus
authors.forename: Lukasz
authors.initials: L
authors.lastname: Rzeszutko
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Danuta
authors.initials: D
authors.lastname: Sorysz
authors.forename: Leszek
authors.initials: L
authors.lastname: Bryniarski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
authors.forename: Grzegorz L
authors.initials: GL
authors.lastname: Kaluza
authors.forename: Jacek S
authors.initials: JS
authors.lastname: Dubiel
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D013318:Stroke Volume; D013997:Time Factors; D014654:Vascular Patency / Q000187:drug effects; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab