Key result
Compared to intracoronary urokinase, abciximab reduced repeat revascularization and noncardiac bleeding complications in early coronary stent thrombosis.
Why the study?
Does abciximab reduce repeat revascularization and complications compared to intracoronary urokinase in patients with early coronary stent thrombosis?
Cohort (n=74)
Does abciximab reduce repeat revascularization and complications compared to intracoronary urokinase in patients with early coronary stent thrombosis?
In patients with early coronary stent thrombosis, abciximab reduces the need for repeat revascularization and bleeding complications compared to intracoronary urokinase.
Answers are grounded in this paper and cite their sources.
Abciximab was associated with fewer repeat revascularizations and bleeding events than urokinase; leaves open need for randomized confirmation.
AIMS: This study evaluated the treatment of early coronary stent thrombosis with intracoronary urokinase or the platelet glycoprotein IIb/IIIa receptor inhibitor ReoPro (abciximab). METHODS AND RESULTS: Seventy-four patients (126 stents) were treated immediately after identification of early (0-30 days) coronary stent thrombosis. Twenty-nine patients were treated with intracoronary urokinase (UK) (UK alone in 19; UK and additional balloon angioplasty in 10) and another 45 patients were given ReoPro((R)) (abciximab) (0.25 mg/kg as a bolus alone in 26, abciximab with additional balloon angioplasty in 19) within 30 days of stent implantation. TIMI grade 3 flow was obtained in 23 patients (79%) in the UK group and in 38 (84%) in the abciximab group (nonsignificant). Three patients (10%) in the UK group and one (2%) in the abciximab group underwent repeat percutaneous transluminal coronary angioplasty (PTCA) (nonsignificant). Five patients (17%) in the UK group and three (7%) in the abciximab group were referred for urgent coronary artery bypass graft surgery (CABG) because of residual thrombus and refractory ischemia (nonsignificant). Repeat revascularization was necessary in eight patients (28%) in the UK group versus four (9%) in the abciximab group (p < 0.05). Five patients (17%) in the UK group and eight (18%) in the abciximab group developed myocardial infarction (nonsignificant). Five patients (17%) in the UK group (cardiogenic shock (three), cerebral hemorrhage (one) and pneumonia (one)) and three (6.6%) in the abciximab group (cardiogenic shock (two), heart failure (one)) died within 30 days (nonsignificant). Overall, noncardiac complications (bleeding including surgical repair of groin) were observed in 11 patients (38%) in the UK group and three (7%) in the abciximab group (p < 0.001). CONCLUSION: Compared to urokinase, abciximab reduced the need for repeat revascularization procedures and the risk of noncardiac events, including bleeding complications in patients with early coronary stent thrombosis.
No takes yet. Share an insight, caveat, or question.
Mamtimin et al. (2000) conducted a cohort in Early coronary stent thrombosis (n=74). ReoPro (abciximab) vs. Intracoronary urokinase was evaluated on Repeat revascularization (p=< 0.05). Compared to intracoronary urokinase, abciximab reduced repeat revascularization and noncardiac bleeding complications in early coronary stent thrombosis.
Synapse has enriched 10 related papers. Consider them for comparative context: