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Efficacy of abciximab readministration in coronary intervention.

Publication ,  Journal Article
Madan, M; Kereiakes, DJ; Hermiller, JB; Rund, MM; Tudor, G; Anderson, L; McDonald, MB; Berkowitz, SD; Sketch, MH; Phillips, HR; Tcheng, JE
Published in: Am J Cardiol
February 15, 2000

Abciximab, an Fab monoclonal antibody fragment that blocks the platelet glycoprotein IIb/IIIa receptor, is increasingly used as an adjunct to coronary intervention. Little is known, however, about the efficacy and safety of readministration of abciximab. This study examined and characterized outcomes of patients receiving abciximab for a second time. From April 1995 to June 1997, 164 consecutive patients were readministered abciximab at our 3 institutions. We retrospectively examined and analyzed in-hospital outcomes in this cohort. The median time to readministration was 95 days. The angiographic success rate of percutaneous intervention was 99.5%. Rates and 95% confidence intervals of in-hospital events were death 2% (0.7% to 6.1%), myocardial infarction 3% (1% to 7%), coronary bypass surgery 0% (0% to 2.2%), and intracranial hemorrhage 2% (0.4% to 5.3%). Severe thrombocytopenia was observed in 4% of patients (1.4% to 7.8%) after readministration. Allergic or anaphylactic reactions were not observed. Major bleeding was associated with excessive concomitant antithrombotic therapy. Patients undergoing readministration of abciximab within 2 weeks of first administration experienced a higher incidence of severe thrombocytopenia (12% vs. 2%, p = 0.046). Thus, abciximab remains clinically efficacious when readministered as an adjunct to percutaneous coronary intervention. However, concomitant heparin administration must be carefully monitored and warfarin therapy should be avoided. Vigilant surveillance for thrombocytopenia should be employed. Reduced dosing may be necessary when abciximab is readministered within days of the initial administration.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

February 15, 2000

Volume

85

Issue

4

Start / End Page

435 / 440

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombocytopenia
  • Safety
  • Retrospective Studies
  • Postoperative Period
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Myocardial Revascularization
  • Middle Aged
  • Male
 

Citation

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Madan, M., Kereiakes, D. J., Hermiller, J. B., Rund, M. M., Tudor, G., Anderson, L., … Tcheng, J. E. (2000). Efficacy of abciximab readministration in coronary intervention. Am J Cardiol, 85(4), 435–440. https://doi.org/10.1016/s0002-9149(99)00768-7
Madan, M., D. J. Kereiakes, J. B. Hermiller, M. M. Rund, G. Tudor, L. Anderson, M. B. McDonald, et al. “Efficacy of abciximab readministration in coronary intervention.Am J Cardiol 85, no. 4 (February 15, 2000): 435–40. https://doi.org/10.1016/s0002-9149(99)00768-7.
Madan M, Kereiakes DJ, Hermiller JB, Rund MM, Tudor G, Anderson L, et al. Efficacy of abciximab readministration in coronary intervention. Am J Cardiol. 2000 Feb 15;85(4):435–40.
Madan, M., et al. “Efficacy of abciximab readministration in coronary intervention.Am J Cardiol, vol. 85, no. 4, Feb. 2000, pp. 435–40. Pubmed, doi:10.1016/s0002-9149(99)00768-7.
Madan M, Kereiakes DJ, Hermiller JB, Rund MM, Tudor G, Anderson L, McDonald MB, Berkowitz SD, Sketch MH, Phillips HR, Tcheng JE. Efficacy of abciximab readministration in coronary intervention. Am J Cardiol. 2000 Feb 15;85(4):435–440.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

February 15, 2000

Volume

85

Issue

4

Start / End Page

435 / 440

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombocytopenia
  • Safety
  • Retrospective Studies
  • Postoperative Period
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Myocardial Revascularization
  • Middle Aged
  • Male