title: Relationship between early administration of abciximab and TIMI flow in STEMI patients undergoing primary angioplasty: findings from a large regional STEMI network.
abstract: OBJECTIVE
  The aim of this study is to assess whether in S-T Elevation Myocardial Infarction (STEMI) a relationship between early administration of abciximab and Thrombolysis In Myocardial Infarction (TIMI) flow before and after primary percutaneous coronary intervention (PCI) in 960 consecutive patients exists.
  
  
  METHODS
  From 1 February 2001 onward, in the Province of Mantua it has been operating a 'Cardiology Network for the Acute Infarction Care' having its Hub in the Central Coronary ICU/Cath Lab of Mantua Hospital and being its Spokes centers represented by the emergency rooms and Central Coronary ICUs of the four territorial hospitals.
  
  
  RESULTS
  T1 (time from symptoms onset to first medical contact) and T2 (time from first medical contact to angioplasty) are shorter for patients rescued by first aid units rather than for those presented in emergency rooms as well as Ta (time from symptoms onset to abciximab administration). Furthermore, the patients that received abciximab before hospital arrival had less frequently a coronary occlusion [odds ratio = 0.74, 95% confidence interval (0.57-0.96), P = 0.013]. The patients with T1 less than 4 h are 753/960 (78.4%). For this type of patients, there was a significant Ta difference between the pre-PCI TIMI-flow classes (F = 4.467, df = 3, P = 0.04). Planned contrasts revealed that mean time of TIMI flow 0 (M = 104.2) is statistically different from mean time of TIMI flow 3 (M = 85.7), P = 0.013.
  
  
  CONCLUSIONS
  Our results suggest that the use of abciximab, free from pharmacokinetic limits of oral P2Y12 inhibitors, should be considered in STEMI patients with early presentation before primary PCI.
authors.affiliation: Cardiological Department, 'Biostatistical Service Carlo Poma' Hospital, Mantova, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Izzo
authors.forename: Renato
authors.initials: R
authors.lastname: Rosiello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucchini
authors.forename: Luca
authors.initials: L
authors.lastname: Tomasi
authors.forename: Paola
authors.initials: P
authors.lastname: Mantovani
authors.forename: Corrado
authors.initials: C
authors.lastname: Lettieri
authors.forename: Nicola
authors.initials: N
authors.lastname: Baccaglioni
authors.forename: Michele
authors.initials: M
authors.lastname: Romano
authors.forename: Francesca
authors.initials: F
authors.lastname: Buffoli
authors.forename: Beatrice
authors.initials: B
authors.lastname: Izzo
authors.forename: Roberto
authors.initials: R
authors.lastname: Zanini
mesh_terms: D000077284:Abciximab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab