title: Effect of abciximab on clinical and angiographic restenosis in patients with non-ST-segment elevation acute coronary syndromes.
abstract: The ISAR-REACT 2 trial was designed to assess the effect of abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after a 600-mg loading dose of clopidogrel. The aim of the present study was to investigate the impact of abciximab on clinical and angiographic restenosis after coronary stenting in patients with acute coronary syndromes. The angiographic substudy included 1,544 patients from the ISAR-REACT 2 trial randomly assigned to abciximab (771 patients) or placebo (773 patients). All patients were scheduled for routine angiographic follow-up at 6 to 8 months after intervention. The primary end point was incidence of angiographic in-segment binary restenosis. The secondary end point was 1-year incidence of target-lesion revascularization. Binary restenosis was observed in 21.9% of patients in the abciximab group and 24.5% of patients in the placebo group (p=0.29). Percentages of in-stent (29+/-22% vs 33+/-24%; p=0.02) and in-segment (35+/-20% vs 38+/-21%; p=0.04) diameter stenoses were significantly lower in the abciximab group than the placebo group. There was a strong trend toward lower 1-year incidence of target-lesion revascularization in patients treated with abciximab than in patients treated with placebo (13.6% vs 16.8%; p=0.08). In conclusion, in patients with non-ST-segment elevation acute coronary syndromes undergoing early percutaneous coronary intervention with stenting after a 600-mg loading dose of clopidogrel, abciximab therapy may have a slight positive impact on the prevention of restenosis.
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany. ijima@dhm.mhn.de
authors.forename: Raisuke
authors.initials: R
authors.lastname: Iijima
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Josef
authors.initials: J
authors.lastname: Dirschinger
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pache
authors.forename: Melchior
authors.initials: M
authors.lastname: Seyfarth
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000077284:Abciximab; D054058:Acute Coronary Syndrome / Q000150:complications* / Q000628:therapy*; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D000077144:Clopidogrel; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D000077284:Abciximab