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ACC: Bolus Intracoronary Abciximab Reduces Infarct Size

Delivery to infarct lesion site reduces size for patients with STEMI undergoing primary PCI

MONDAY, March 26 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), administration of bolus intracoronary abciximab to the infarct site reduces the infarct size, according to a study published online March 25 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 24 to 27 in Chicago.

Gregg W. Stone, M.D., from Columbia University Medical Center in New York City, and colleagues randomized 452 patients presenting within four hours of STEMI, undergoing primary PCI with bivalirudin anticoagulation, to receive bolus intracoronary abciximab delivered at the infarct lesion site versus no abciximab (181 versus 172 patients) and to manual aspiration thrombectomy versus no thrombectomy (174 versus 179 patients). Infarct size was assessed by cardiac magnetic resonance imaging at 30 days.

The researchers observed a significant reduction in infarct size in those randomized to intracoronary abciximab versus no abciximab (15.1 versus 17.9 percent; P = 0.03). A significant reduction was seen in absolute infarct mass, but not in abnormal wall motion, in patients assigned to intracoronary abciximab. There were no significant differences in infarct size at 30 days, absolute infarct mass, or abnormal wall motion score for patients assigned to manual aspiration thrombectomy versus no thrombectomy.

"Infarct size was reduced by bolus intracoronary abciximab delivered to the site of the infarct lesion, but not by manual aspiration thrombectomy," the authors write.

The study was funded by Atrium Medical, who, along with Medtronic and The Medicines Company, provided free or discounted study supplies. Several authors disclosed financial ties to the pharmaceutical, medical device, and biotechnology industries.

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