EVALUATION OF ABCIXIMAB THERAPY IN DISSOLVING NEWLY FORMED
CORONARY THROMBUS DURING CORONARY ANGIOPLASTY AND STENTING C. Gao*, RJ. Whitbourn, A. MacIsaac. Department of Cardiology, St Vincent's
Hospital, Melbourne, Vic. Use of abciximab (ReoProTM) prior to coronary angioplasty
or stenting improves in-hospital and long-term clinical outcomes.
However, ability to abciximab to acutely dissolve coronary thrombus
which forms during a coronary intervention has not been defined.
Of 1052 consecutive coronary interventional procedures, 72 patients,
were found to have thrombus that newly developed during cardiac
intervention, were given abciximab either as an intravenous bolus,
followed by 12 hours infusion (standard ReoPro protocol) or as a
bolus alone. Coronary angiograms of patients with thrombus
developing in the catheter lab were analysed and TIMI flow and a
coronary thrombus score were determine pre-, during and post procedure
according to AHA/ACC criteria. Stenting PTCA Standard
ReoPro ReoPro
Bolus only Any
site bleed 26
(53.06) 10
(43.48) 21
(52.50) 15
(46.88) Access
site haematoma 5
(8.16) 1
(4.34) 5
(12.50) 1
(3.12) Pericardial
bleed 1
(2.04) 0 1
(2.50) 0 Thrombocytopenia 1
(2.04) 0 1
(2.50) 0 Blood
transfusion 2
(4.08) 0 2
(5.00) 0 Stroke 0 1
(4.34) 2
(2.5) 0 Revascularisation
in Hosp. 0 0 0 0 CABGs 0 1
(4.34) 0 1
(3.12) Non-Q-MI 2
(4.08) 2
(8.68) 2
(5.0) 2
(6.25) Death 0 0 0 0 In patients who developed thrombus during an interventional procedure,
a higher thrombus score was seen in PTCA treated patients compared
to stented patients, both before (2.3±1.5 vs 1.8±1.3,
p<0.05) and after (1.3±1.4∆- vs 0.3±0.8,
p<0.05) ReoPro treatment. Patients treated with standard
ReoPro protocol had more bleeding complications p<0/01, whilst
myocardial infarction, death and revascularization in hospital were
not different in the two groups. ReoPro bolus only has at
least equivalent clinical effect as standard ReoPro protocol and
has less tendency to bleeding complications.
(n=49)
(n=29)
(n=40)
(n=32)
