Journal Article

One year outcomes with abciximab vs. placebo during percutaneous coronary intervention after pre-treatment with clopidogrel<sup>†</sup>

Albert Schömig, Claus Schmitt, Alban Dibra, Julinda Mehilli, Christian Volmer, Helmut Schühlen, Josef Dirschinger, Franz Dotzer, Jurriën M. ten Berg, Franz-Josef Neumann, Peter B. Berger and Adnan Kastrati

in European Heart Journal

Published on behalf of European Society of Cardiology

Volume 26, issue 14, pages 1379-1384
Published in print July 2005 | ISSN: 0195-668x
Published online February 2005 | e-ISSN: 1522-9645 | DOI: http://dx.doi.org/10.1093/eurheartj/ehi174
One year outcomes with abciximab vs. placebo during percutaneous coronary intervention after pre-treatment with clopidogrel†

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Aims In the Intracoronary Stenting and Antithrombotic Regimen-Rapid Early Action for Coronary Treatment Trial, the use of abciximab in patients undergoing percutaneous coronary intervention (PCI) after pretreatment with 600 mg clopidogrel for >2 h was associated with no clinically measurable benefit at 30 days. We assessed whether there was any clinical benefit from abciximab at 1 year follow-up.

Methods and results After pre-treatment with 600 mg clopidogrel, a total of 2159 patients undergoing PCI for stable or unstable angina without marked ST-segment shifts or positive biomarkers were randomly assigned to receive abciximab or placebo. The occurrence of the composite endpoint of death, myocardial infarction, or target vessel revascularization was assessed at 1 year after randomization.

At 1 year, the composite endpoint occurred in 23.8% of the patients in each group [relative risk (RR), 1.01; 95% confidence interval (CI), 0.85–1.20; P=0.92]. The combined incidence of death and myocardial infarction was 6.0% in the abciximab group and 6.4% in the placebo group (RR, 0.94; 95% CI, 0.67–1.32; P=0.73). The mortality rate was 2.1% in the abciximab group and 2.4% in the placebo group (RR, 0.88; 95% CI, 0.50–1.54; P=0.66). No trend towards clinical benefit was observed with abciximab at 1 year in any subgroup analysed.

Conclusion In patients with a low-to-intermediate risk profile undergoing PCI after pre-treatment with a 600 mg clopidogrel for at least 2 h, the use of abciximab offers no additional clinical benefit at 1 year.

Keywords: Angina; Angioplasty; Platelets; Stents; Thrombosis

Journal Article.  3808 words.  Illustrated.

Subjects: Cardiovascular Medicine

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