Skip Navigation


European Heart Journal Advance Access originally published online on January 24, 2007
European Heart Journal 2007 28(4):443-449; doi:10.1093/eurheartj/ehl472
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
28/4/443    most recent
ehl472v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (24)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Montalescot, G.
Right arrow Articles by Vicaut, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Montalescot, G.
Right arrow Articles by Vicaut, E.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Abciximab in primary coronary stenting of ST-elevation myocardial infarction: a European meta-analysis on individual patients' data with long-term follow-up

Gilles Montalescot1,*, David Antoniucci2, Adnan Kastrati3, Franz Joseph Neumann4, Maria Borentain1, Angela Migliorini2, Carole Boutron5, Jean-Philippe Collet1 and Eric Vicaut5

1 Institute of Cardiology (APHP) and INSERM unit #856, Pitié-Salpêtrière University Hospital, 47 Boulevard de l'Hôpital, 75013 Paris, France
2 Division of Cardiology, Careggi Hospital, Florence, Italy
3 Deutsches Herzzentrum, Technische Universität München, Munich, Germany
4 Herz-Zentrum, Bad Grozingen, Germany
5 Unité de Recherche Clinique (Statistics department), Lariboisière University Hospital, Paris, France

Received 2 June 2006; revised 14 December 2006; accepted 21 December 2006; online publish-ahead-of-print 24 January 2007.

* Corresponding author. Tel: +33 1 42 16 30 06; fax: +33 1 42 16 29 31. E-mail address: gilles.montalescot{at}psl.aphp.fr

Aims Varying results have been reported in studies evaluating glycoprotein (GP) IIb/IIIa inhibition in primary coronary stenting of acute ST-elevation myocardial infarction (STEMI), usually with limited clinical follow-up. We performed a meta-analysis on case specific data of primary stenting in STEMI with a long-term evaluation.

Methods and results For this meta-analysis, studies of rescue percutaneous coronary intervention (PCI) after failed lytic therapy, plain balloon angioplasty studies and studies with an angiographic selection of patients were excluded. The ISAR-2, ADMIRAL, and ACE studies fulfilled inclusion criteria and all individual data were analysed together. The primary endpoint was the composite of death or re-infarction up to 3 years of follow-up. A total of 1101 patients, presenting for primary PCI and stenting of STEMI were randomized to abciximab (n = 550) or placebo (n = 551). This population had high-risk characteristics with 41% of anterior MI, 30% with a prior history of MI, 8.4% of cardiogenic shock, and 3.1% of previous coronary artery bypass graft (CABG). The primary endpoint of death or re-infarction was significantly reduced from an estimated cumulative hazard rate of 19.0% with placebo to 12.9% with abciximab [RR(95% IC): 0.633 (0.452; 0.887), P = 0.008]. The mortality rate was reduced from an estimated cumulative hazard rate of 14.3% in the placebo arm to 10.9% in the abciximab arm [0.695 (0.482; 1.003), P = 0.052]. Re-infarction was reduced from an estimated cumulative hazard rate of 5.5% with placebo to 2.3% with abciximab [0.41 (0.203; 0.831), P = 0.013]. Major bleedings were 2.5 and 2% with and without abciximab, respectively (NS). In the control arm, both the death or MI cumulative hazard rate (54 vs. 13.5%) and mortality rate (39.7 vs. 10.1%) were four-fold higher in diabetics when compared with non-diabetics. Abciximab provided a significant benefit on the primary endpoint for diabetics [0.525 (0.303; 0.911), P = 0.022].

Conclusion Abciximab has a strong and persistent impact on hard clinical endpoints in patients undergoing primary stenting for STEMI.

Key Words: Primary percutaneous coronary intervention • Stent • GP IIb/IIIa inhibitors • Abciximab • Myocardial infarction


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
Eur Heart JHome page
G. De Luca, E. Navarese, and P. Marino
Risk profile and benefits from Gp IIb-IIIa inhibitors among patients with ST-segment elevation myocardial infarction treated with primary angioplasty: a meta-regression analysis of randomized trials
Eur. Heart J., November 2, 2009; 30(22): 2705 - 2713.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. P. Bonaca, P. G. Steg, L. J. Feldman, J. F. Canales, J. J. Ferguson, L. Wallentin, R. M. Califf, R. A. Harrington, and R. P. Giugliano
Antithrombotics in acute coronary syndromes.
J. Am. Coll. Cardiol., September 8, 2009; 54(11): 969 - 984.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
G. Niccoli, F. Burzotta, L. Galiuto, and F. Crea
Myocardial no-reflow in humans.
J. Am. Coll. Cardiol., July 21, 2009; 54(4): 281 - 292.
[Abstract] [Full Text] [PDF]


Home page
Circ Cardiovasc IntervHome page
H. S. Gurm, U. Tamhane, P. Meier, P. M. Grossman, S. Chetcuti, and E. R. Bates
A Comparison of Abciximab and Small-Molecule Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Primary Percutaneous Coronary Intervention: A Meta-Analysis of Contemporary Randomized Controlled Trials
Circ Cardiovasc Interv, June 1, 2009; 2(3): 230 - 236.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
G. De Luca, G. Ucci, E. Cassetti, and P. Marino
Benefits from small molecule administration as compared with abciximab among patients with ST-segment elevation myocardial infarction treated with primary angioplasty: a meta-analysis.
J. Am. Coll. Cardiol., May 5, 2009; 53(18): 1668 - 1673.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
J. Mehilli, A. Kastrati, S. Schulz, S. Frungel, S. G. Nekolla, W. Moshage, F. Dotzer, K. Huber, J. Pache, J. Dirschinger, et al.
Abciximab in Patients With Acute ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention After Clopidogrel Loading: A Randomized Double-Blind Trial
Circulation, April 14, 2009; 119(14): 1933 - 1940.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
M. L. Fokkema, P. J. Vlaar, T. Svilaas, M. Vogelzang, D. Amo, G. F.H. Diercks, A. J.H. Suurmeijer, and F. Zijlstra
Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction
Eur. Heart J., April 2, 2009; 30(8): 908 - 915.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
A. Marzocchi, A. Manari, G. Piovaccari, C. Marrozzini, S. Marra, P. Magnavacchi, P. Sangiorgio, L. Marinucci, N. Taglieri, G. Gordini, et al.
Randomized comparison between tirofiban and abciximab to promote complete ST-resolution in primary angioplasty: results of the facilitated angioplasty with tirofiban or abciximab (FATA) in ST-elevation myocardial infarction trial
Eur. Heart J., December 2, 2008; 29(24): 2972 - 2980.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
G De Luca, C M Gibson, F Bellandi, S Murphy, M Maioli, M Noc, U Zeymer, D Dudek, H-R Arntz, S Zorman, et al.
Early glycoprotein IIb-IIIa inhibitors in primary angioplasty (EGYPT) cooperation: an individual patient data meta-analysis
Heart, December 1, 2008; 94(12): 1548 - 1558.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart J SupplHome page
D. Antoniucci
The balance between bleeding and ischaemic complications in percutnaeous coronary intervention practice
Eur. Heart J. Suppl., December 1, 2008; 10(suppl_J): J21 - J25.
[Full Text] [PDF]


Home page
JAMAHome page
M. Valgimigli, G. Campo, G. Percoco, L. Bolognese, C. Vassanelli, S. Colangelo, N. de Cesare, A. E. Rodriguez, M. Ferrario, R. Moreno, et al.
Comparison of Angioplasty With Infusion of Tirofiban or Abciximab and With Implantation of Sirolimus-Eluting or Uncoated Stents for Acute Myocardial Infarction: The MULTISTRATEGY Randomized Trial
JAMA, April 16, 2008; 299(15): 1788 - 1799.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
M. Roffi and D. Mukherjee
Platelet glycoprotein IIb/IIIa receptor inhibitors--end of an era?
Eur. Heart J., February 2, 2008; 29(4): 429 - 431.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
American College of Cardiology/American Heart Asso, Developed in Collaboration With the Canadian Cardi, Endorsed by the American Academy of Family Physici, 2007 Writing Group to Review New Evidence and Upda, E. M. Antman, M. Hand, P. W. Armstrong, E. R. Bates, L. A. Green, L. K. Halasyamani, et al.
2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction
J. Am. Coll. Cardiol., January 15, 2008; 51(2): 210 - 247.
[Full Text] [PDF]


Home page
CirculationHome page
E. M. Antman, M. Hand, P. W. Armstrong, E. R. Bates, L. A. Green, L. K. Halasyamani, J. S. Hochman, H. M. Krumholz, G. A. Lamas, C. J. Mullany, et al.
2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the Canadian Cardiovascular Society Endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee
Circulation, January 15, 2008; 117(2): 296 - 329.
[Full Text] [PDF]


Home page
Eur Heart J SupplHome page
A. K. Gitt and A. Betriu
Antiplatelet therapy in acute coronary syndromes
Eur. Heart J. Suppl., January 1, 2008; 10(suppl_A): A4 - A12.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart J SupplHome page
C. Bode and K. Huber
Antiplatelet therapy in percutaneous coronary intervention
Eur. Heart J. Suppl., January 1, 2008; 10(suppl_A): A13 - A20.
[Abstract] [Full Text] [PDF]



Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.