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Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials.

Publication ,  Journal Article
Kubica, J; Koziński, M; Navarese, EP; Tantry, US; Grześk, G; Fabiszak, T; Kubica, A; Świątkiewicz, I; Bliden, KP; Gurbel, PA
Published in: Cardiol J
2012

BACKGROUND: Intracoronary (IC) abciximab administration remains a promising approach aimed to increase a drug concentration in the target area and possibly improve clinical outcomes in the setting of ST-segment elevation myocardial infarction (STEMI). The goal of this literature review and meta-analysis is to update available knowledge comparing IC and intravenous (IV) abciximab administration in STEMI patients. METHODS: A total of 7 randomized clinical trials (RCTs) with a median follow-up of 3 months were included in the meta-analysis (n = 3311). All-cause mortality was selected as the primary end point while recurrent myocardial infarction (re-MI), target vessel revascularization (TVR) and major bleeding complications were the secondary end points. RESULTS: IC abciximab did not provide any benefits in terms of all-cause mortality as compared with IV abciximab (odds ratio [OR] 0.67; 95% confidence interval [CI] 0.34-1.34). However, this neutral effect was driven by the AIDA STEMI trial. The IC route was associated with a reduced rate of re-MI when compared with IV administration (OR 0.61; 95% CI 0.40-0.92) but the difference disappeared after one of the RCTs was excluded from the analysis. Both strategies were equal regarding TVR (OR 0.66; 95% CI 0.40-1.09) and major bleeding complications (OR 1.18; 95% CI 0.76-1.83). CONCLUSIONS: Our updated meta-analysis shows that the clinical superiority of IC over IV abciximab administration in STEMI patients is no longer clear after the release of the AIDA STEMI trial results. Further research in high-risk STEMI patients is warranted to finally determine clinical advantages of IC vs IV abciximab administration.

Duke Scholars

Published In

Cardiol J

DOI

EISSN

1898-018X

Publication Date

2012

Volume

19

Issue

3

Start / End Page

230 / 242

Location

Poland

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Risk Factors
  • Risk Assessment
  • Recurrence
  • Randomized Controlled Trials as Topic
  • Patient Selection
  • Odds Ratio
  • Myocardial Infarction
  • Immunoglobulin Fab Fragments
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kubica, J., Koziński, M., Navarese, E. P., Tantry, U. S., Grześk, G., Fabiszak, T., … Gurbel, P. A. (2012). Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials. Cardiol J, 19(3), 230–242. https://doi.org/10.5603/cj.2012.0044
Kubica, Jacek, Marek Koziński, Eliano P. Navarese, Udaya S. Tantry, Grzegorz Grześk, Tomasz Fabiszak, Aldona Kubica, Iwona Świątkiewicz, Kevin P. Bliden, and Paul A. Gurbel. “Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials.Cardiol J 19, no. 3 (2012): 230–42. https://doi.org/10.5603/cj.2012.0044.
Kubica J, Koziński M, Navarese EP, Tantry US, Grześk G, Fabiszak T, et al. Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials. Cardiol J. 2012;19(3):230–42.
Kubica, Jacek, et al. “Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials.Cardiol J, vol. 19, no. 3, 2012, pp. 230–42. Pubmed, doi:10.5603/cj.2012.0044.
Kubica J, Koziński M, Navarese EP, Tantry US, Grześk G, Fabiszak T, Kubica A, Świątkiewicz I, Bliden KP, Gurbel PA. Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials. Cardiol J. 2012;19(3):230–242.

Published In

Cardiol J

DOI

EISSN

1898-018X

Publication Date

2012

Volume

19

Issue

3

Start / End Page

230 / 242

Location

Poland

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Risk Factors
  • Risk Assessment
  • Recurrence
  • Randomized Controlled Trials as Topic
  • Patient Selection
  • Odds Ratio
  • Myocardial Infarction
  • Immunoglobulin Fab Fragments