One-year clinical outcome of patients treated with or without abciximab in rescue coronary angioplasty

Abstract

BackgroundThe clinical results of abciximab administration during rescue angioplasty (PCI) are poorly investigated. MethodsWe evaluated the outcome of 406 consecutive patients undergoing rescue PCI treated with (n=218) or without (n=188) abciximab and a clopidogrel loading dose of 300mg. The end point was the incidence of major cardiac adverse events (MACE) defined as death, recurrent acute myocardial infarction (AMI) and target vessel revascularization at 30days and 1year. The predictors of MACE were also investigated. ResultsNo differences were found in MACE between the groups treated with or without abciximab at 30days (15 and 20, p=0.67) and 1year (23 and 29, p=0.85). Stepwise logistic regression analysis identified: cardiogenic shock (Odds Ratio [OR]=17.8, 95% confidence interval [CI] 5–99, p=0.0001), age (OR=1.099, 95% CI 1.04–1.15, p=0.0001), TIMI flow 0–1 after procedure (OR=5.51, 95% CI 1.72–17.6, p=0.004) as independent predictors of MACE at 30days. Cox proportional hazards model identified: cardiogenic shock (adjusted hazard ratio [HR]=3.83, 95% confidence interval [CI] 1.76–8.35, p=0.01), age (HR=3.7, 95% CI 1.75–8.3, p=0.01), TIMI flow 0–1 after procedure (HR=1.04, 95% CI 1.01–1.07, p=0.001 as predictors of MACE at 1year). After propensity score adjustments the predictors of MACE did not change. ConclusionThere were no differences in MACE at 30days and 1year in patients treated with or without abciximab during rescue PCI after a clopidogrel loading dose of 300mg. Cardiogenic shock, age and TIMI flow 0 and 1 after PCI were predictors of MACE.