Comparison of Abciximab Combined With Dalteparin or Unfractionated Heparin in High-Risk Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients

Abstract

The purpose of this study was to determine the clinical outcomes of abciximab combined with the low molecular weight heparin (LMWH), dalteparin, in high-risk percutaneous coronary intervention (PCI) patients with acute myocardial infarction (AMI). A total of 140 high-risk PCI patients with AMI were divided into 2 groups: unfractionated heparin (UFH) with abciximab (group I: 70 patients, 58.7 +/- 10.5 years), and dalteparin with abciximab (group II: 70 patients, 59.6 +/- 9.8 years). Major adverse cardiac events (MACE) during hospitalization and at 4 years after PCI were examined. Baseline clinical characteristics, laboratory findings, echocardiography parameters, and baseline angiographic characteristics were not different between the 2 groups. The incidence of thrombotic total occlusion lesions was 62.9% in both groups. Procedural success was achieved in 91.4% in group I and 90.0% in group II. Bleeding and hemorrhagic events were not different between the 2 groups. No significant intracranial bleeding was observed in either group. The incidence of in-hospital MACE was 7 (10.0%) in group I and 4 (5.7%) in group II. Four-year clinical follow-up was performed in 97% of the patients. Four years after PCI, death occurred in 6 (8.6%) patients in group I and in 7 (10.0%) in group II. MI occurred in 4 (5.7%) and 4 (5.7%), target vessel revascularization (TVR) in 23 (32.9%) and 16 (22.9%), and bypass surgery in 3 (4.3%) and 1 (1.4%), respectively. Overall, a MACE occurred in 33 (47.1%) patients in group I and in 26 (35.1%) patients in group II (P = 0.23). The long-term clinical outcome with dalteparin combined with abciximab may be comparable to that of UFH plus abciximab in high risk PCI patients with AMI.