Abciximab therapy during primary PCI for STEMI complicated by cardiogenic shock did not significantly improve 1-year survival compared to no abciximab (adjusted HR for death 1.08; 95% CI 0.70-1.60).
Cohort (n=410)
Does abciximab improve survival in patients with STEMI complicated by cardiogenic shock undergoing primary PCI?
In patients with STEMI complicated by cardiogenic shock undergoing primary PCI, the use of abciximab did not significantly improve 1-year survival.
Effect estimate: HR 1.08 (95% CI 0.70-1.60)
Absolute Event Rate: 51.6% vs 42.8%
p-value: p=0.60
BACKGROUND: The effect of abciximab on survival in patients with ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) undergoing primary percutaneous coronary intervention (PCI) is not clear. METHODS AND RESULTS: We evaluated outcome in 410 consecutive patients with STEMI and CS who underwent PCI treated without (n=123) or with (n=287) abciximab. The endpoint was survival at 1-year follow-up. The predictors of death at 1 year were also investigated. The groups with and without abciximab had similar survival at 1-year follow-up. Propensity score-adjusted Cox proportional hazards model identified age (adjusted hazard ratio HR, 1.02; 95% confidence interval 95% CI: 1.01-1.03, P=0.001), oro-tracheal intubation (HR, 1.49; 95% CI: 1.12-1.96, P=0.05), post-PCI TIMI flow grade 0-1 (HR, 2.08; 95% CI: 1.52-2.83, P=0.0001) but not abciximab use (HR, 1.08; 95% CI: 0.70-1.60, P=0.60) as independent predictors of death at 1-year follow-up. Cox adjusted 1-year survival rates were 42.8% and 51.6%, (P=0.56) in patients treated without vs. with abciximab, respectively. CONCLUSIONS: Patients with STEMI complicated by CS undergoing PCI treated with or without abciximab have similar 1-year survival rates; age, final TIMI 0-1 and oro-tracheal intubation are predictors of death.
Felice et al. (Thu,) conducted a cohort in ST-elevation myocardial infarction complicated by cardiogenic shock (n=410). Abciximab vs. No abciximab was evaluated on Survival at 1-year follow-up (HR 1.08, 95% CI 0.70-1.60, p=0.60). Abciximab therapy during primary PCI for STEMI complicated by cardiogenic shock did not significantly improve 1-year survival compared to no abciximab (adjusted HR for death 1.08; 95% CI 0.70-1.60).