title: Intracoronary versus intravenous administration of abciximab in patients with acute coronary syndrome: a meta-analysis.
abstract: BACKGROUND
  Abciximab is a widely used adjunctive therapy for acute coronary syndrome (ACS). However, the effect of intracoronary (i.c.) administration of abciximab on cardiovascular events remains unclear when compared with intravenous (i.v.) therapy.
  
  
  RESULTS
  We systematically searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases and reference lists of articles and proceedings of major meetings for obtaining relevant literature. All eligible trials included ACS patients who received either i.c. administration of abciximab or i.v. therapy. The primary outcome was major cardiovascular events, and secondary outcomes included total mortality, reinfarction, and any possible adverse events. Of 660 identified studies, we included 9 trials reporting data on 3916 ACS patients. Overall, i.c. administration of abciximab resulted in 45% reduction in relative risk for major cardiovascular events (RR; 95% confidence interval [CI], 24-60%), 41% reduction in RR for reinfarction (95% CI, 7-63%), and 44% reduction in RR for congestive heart failure relative to i.v. therapy (95% CI, 8-66%); however, compared to i.v. therapy, i.c. administration of abciximab had no effect on total mortality (RR, 0.69; 95% CI, 0.45-1.07). No other significant differences were identified between the effect of i.c. abciximab administration and i.v. therapy.
  
  
  CONCLUSIONS
  I.c. administration of abciximab can reduce the risk of major cardiovascular events, reinfarction, and congestive heart failure when compared with i.v. therapy.
authors.affiliation: Director of the Hospital, Shanghai Seventh People's Hospital, Shanghai, China.
authors.forename: Jie-Ning
authors.initials: JN
authors.lastname: Wang
authors.forename: Shu
authors.initials: S
authors.lastname: Diao
authors.forename: Yuan-Jun
authors.initials: YJ
authors.lastname: Tang
authors.forename: An-Ji
authors.initials: AJ
authors.lastname: Hou
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Yuan
authors.forename: Yan
authors.initials: Y
authors.lastname: Zheng
authors.forename: Yu-Hao
authors.initials: YH
authors.lastname: Zhou
mesh_terms: D000077284:Abciximab; D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D061605:Administration, Intravenous; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D003331:Coronary Vessels; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab