How does intracoronary abciximab administration affect the outcome of percutaneous coronary intervention (PCI) for the treatment of STEMI?

Updated: Nov 27, 2019
  • Author: George A Stouffer, III, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

Intracoronary abciximab administration, in comparison with the intravenous (IV) standard route, can improve short-term clinical outcomes in patients with STEMI undergoing primary PCI.

A pooled analysis of individual data of 1198 patients enrolled in five trials showed that intracoronary abciximab administration, as compared with IV abciximab, significantly reduced the risk of the composite of death and reinfarction and death. After correction for baseline differences, there were no significant differences in target vessel revascularization or the risk of reinfarction. [55]

However, most of the evidence for these drugs was obtained in the era before early dual antiplatelet therapy (DAPT). A later randomized trial using bivalirudin and either prasugrel or clopidogrel in 452 patients with an anterior STEMI reported an improvement in infarct size (17.9% vs 15.1%) with intracoronary abciximab use. [56]


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