title: Similar anti-inflammatory effects of intracoronary and intravenous abciximab during primary percutaneous coronary intervention: a randomized study.
abstract: BACKGROUND
  Intracoronary Abciximab administration during primary percutaneous coronary intervention (pPCI) could offer theoretical advantages over the intravenous route. Besides antiplatelet effects, Abciximab can modulate inflammation via cross-reactivity with GPIIb/IIIa, avb3, and aMb2 receptors. The aim of our study was to assess whether the Abciximab administration route could influence its anti-inflammatory effects.
  
  
  METHODS
  Eighty-nine consecutive ST elevation myocardial infarction patient candidates for pPCI were randomized to intracoronary (Group A-47 patients) or intravenous (Group B-42 patients) Abciximab bolus administration. The primary endpoint was the extent of inflammation, measured by C-reactive protein (CRP), vascular cell adhesion molecule 1 (VCAM-1) and inter-cellular adhesion molecule 1 (ICAM-1) levels. This study is registered with ClinicalTrials.gov, NCT01757457.
  
  
  RESULTS
  Data are expressed in medians (interquartiles). In both groups, troponin levels were similar [baseline: 0.12 (0.03-0.94) vs. 0.27 (0.07-1.24) ng/ml, P = 0.73; postprocedural: 22.00 (14.75-69.43) vs. 31.96 (8.23-7.20) ng/ml, P = 0.83]. Both groups also showed similar baseline [0.31 (0.14-0.69) vs. 0.22 (0.09-0.59) mg/ml, P = 0.80] and postprocedural CRP levels [2.28 (1.37-4.23) vs. 2.16 (1.15-3.22) mg/dl, P = 0.69], similar baseline [272.5 (224.7-340.8) vs. 262.2 (221.2-306.4) ng/ml, P = 0.33] and postprocedural soluble ICAM-1 levels [281.5 (244.6-337.4) vs. 287.2 (226.9-359.2) ng/ml P = 0.71], and similar baseline [771.6 (620.9-971.0) vs. 748.6 (592.2-838.8) ng/ml, P = 0.30] and postprocedural soluble VCAM-1 levels [785.2 (671.6-947.1) vs. 745.9 (641.1-841.9) ng/ml, P = 0.17]. In-hospital and 6-month event rates were similar in the two groups.
  
  
  CONCLUSIONS
  Our study suggests that Abciximab has similar anti-inflammatory effects irrespective of the administration route. It is unlikely that the potential clinical benefits of intracoronary Abciximab can be related to modulation of integrin receptors.
authors.affiliation: aDepartment of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara bDivision of Interventional Cardiology, 'Ospedali Riuniti Marche Nord', Pesaro cHospital Cardiology dClinical Chemistry, 'Maggiore della Carità' Hospital, Novara, Italy eDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands fBiomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
authors.forename: Gioel Gabrio
authors.initials: GG
authors.lastname: Secco
authors.forename: Mara
authors.initials: M
authors.lastname: Sansa
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.forename: Rosario
authors.initials: R
authors.lastname: Parisi
authors.forename: Rossella
authors.initials: R
authors.lastname: Fattori
authors.forename: Lidia
authors.initials: L
authors.lastname: Rossi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lazzero
authors.forename: Roberta
authors.initials: R
authors.lastname: Rolla
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bellomo
authors.forename: Angelo Sante
authors.initials: AS
authors.lastname: Bongo
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Agostoni
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lupi
mesh_terms: D000077284:Abciximab; D061605:Administration, Intravenous; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007249:Inflammation / Q000097:blood / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab