Abciximab: a reappraisal of its use in coronary care.
Platelet reactivity plays a pivotal role in the pathogenesis of ischemic adverse events during and after acute coronary syndromes (ACS), and percutaneous coronary intervention (PCI). Glycoprotein (GP) IIb/IIIa inhibitors are the strongest antiplatelet agents currently available on the market and three different compounds, namely abciximab, tirofiban, and eptifibatide, have been approved for clinical use. Abciximab has been investigated in the clinical field far more extensively than the other GPIIb/IIIa inhibitors. Abciximab is an anti-integrin Fab fragment of a human - mouse chimeric monoclonal antibody with high affinity and a slow dissociation rate from the GP IIb/IIIa platelet receptor. Abciximab, given shortly before the coronary intervention, is superior to placebo in reducing the acute risk of ischemic complications (EPIC, EPISTENT, EPILOG trials); moreover, in the ISAR-REACT 2 study abciximab has been shown to reduce the risk of adverse events in patients with non ST-segment elevation ACS who are undergoing PCI even after optimal pre-treatment with 600 mg of clopidogrel. Finally, abciximab has been also used in abciximab-coated stent, with only bolus administration regimen and for direct intracoronary use with promising results that may extend and/or modify its current use in clinical practice in future.
Valgimigli
Marco
M
Cardiovascular Institute, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy and Cardiovascular Research Centre, Salvatore Maugeri Foundation, IRCCS Gussago (BS), Italy.
Campo
Gianluca
G
Tebaldi
Matteo
M
Carletti
Roberto
R
Arcozzi
Chiara
C
Ferrari
Roberto
R
Percoco
Gianfranco
G
Chest. 2005 Feb;127(2 Suppl):53S-59S
15706031
N Engl J Med. 2004 Jan 15;350(3):232-8
14724302
Circulation. 2003 Nov 11;108(19):e138; author reply e138
14610001
Clin Ther. 2003 Jan;25(1):225-34
12637122
J Am Coll Cardiol. 2006 Feb 7;47(3):522-8
16458130
Lancet. 1997 May 17;349(9063):1429-35
9164316
J Am Coll Cardiol. 2006 Feb 7;47(3):685-6
16458158
JAMA. 2005 May 4;293(17):2109-17
15870414
N Engl J Med. 1998 Aug 13;339(7):436-43
9705684
Lancet. 1999 Jan 16;353(9148):227-31
9923894
Circulation. 1997 Sep 2;96(5):1445-53
9315530
J Invasive Cardiol. 2006 Nov;18(11):521-6
17090813
J Am Coll Cardiol. 2006 Mar 7;47(5):933-8
16516074
J Pharmacol Exp Ther. 2003 Dec;307(3):969-76
14534354
Mayo Clin Proc. 2007 Feb;82(2):196-202
17290727
J Am Coll Cardiol. 2000 Mar 15;35(4):915-21
10732888
J Am Coll Cardiol. 2002 Oct 2;40(7):1366-74
12383588
Eur Heart J. 2007 Jul;28(13):1598-660
17569677
Am J Cardiol. 2004 Oct 15;94(8):1050-4
15476624
N Engl J Med. 2001 Jun 21;344(25):1895-903
11419426
Circulation. 2002 Sep 17;106(12):1470-6
12234950
Eur Heart J. 2005 Apr;26(8):804-47
15769784
N Engl J Med. 1997 Jun 12;336(24):1689-96
9182212
Am J Cardiol. 2003 Apr 1;91(7):876-8
12667577
J Am Coll Cardiol. 2004 Sep 15;44(6):1187-93
15364318
Circulation. 2006 Dec 12;114(24):2636-43
17145988
Am Heart J. 2006 Nov;152(5):876-81
17070148
Am J Ther. 2004 Jul-Aug;11(4):302-7
15266223
N Engl J Med. 2006 Nov 23;355(21):2203-16
17124018
Circulation. 2004 Jun 29;109(25):3171-5
15184279
Am J Cardiol. 2002 Dec 15;90(12):1421-3
12480064
Lancet. 1998 Jul 11;352(9122):87-92
9672272
J Am Coll Cardiol. 2006 Dec 5;48(11):2178-85
17161242
Lancet. 2001 Jun 16;357(9272):1915-24
11425411
J Am Coll Cardiol. 2007 Aug 14;50(7):e1-e157
17692738
Drugs. 2005;65(3):313-24
15669877
Circulation. 2001 Jul 10;104(2):181-6
11447083
JAMA. 2006 Apr 5;295(13):1531-8
16533938
N Engl J Med. 2001 Jun 21;344(25):1888-94
11419425
Am J Cardiol. 2004 Jul 1;94(1):35-9
15219505
J Clin Pharm Ther. 2004 Dec;29(6):497-510
15584937
N Engl J Med. 1998 May 21;338(21):1488-97
9599103
J Am Coll Cardiol. 2003 Dec 3;42(11):1879-85
14662245
N Engl J Med. 1994 Apr 7;330(14):956-61
8121459
JAMA. 2007 Feb 14;297(6):591-602
17299194
Circulation. 2003 Apr 15;107(14):1840-3
12682003
J Thromb Thrombolysis. 2003 Apr;15(2):71-80
14618072
Eur Heart J. 2007 Feb;28(4):443-9
17251257