Abstract
Abciximab (a glycoprotein IIb/IIIa inhibitor) was assessed in 16 of 36 patients with acute myocardial infarction who were referred for rescue angioplasty after failed thrombolysis. Baseline clinical and angiographic characteristics were comparable in the abciximab and non-abciximab groups. Coronary stenting was carried out in all patients in the non-abciximab group and in 13 in the abciximab group. Angiographic success was achieved in all patients. Persistence of slow flow was encountered more frequently in the non-abciximab group (30% versus 6.25%, p < 0.05). Stent thrombosis occurred in 2 patients (10%) who were successfully redilated and there was one case of bleeding requiring transfusion in the non-abciximab group; neither of these complications occurred in the abciximab group. Predischarge left ventricular ejection fraction was better in the abciximab group (44% ± 3% versus 36% ± 3%, p < 0.01). All patients were discharged alive and were asymptomatic at the one-month follow-up. Use of abciximab during angioplasty after failed thrombolysis improved angiographic and clinical results without increasing the risk of bleeding, and reduced the incidence of in-hospital complications. Larger studies are warranted to confirm this important observation.
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