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

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dc.contributor.author Kubica, Jacek
dc.contributor.author Koziński, Marek
dc.contributor.author Navarese, Eliano Pio
dc.contributor.author Tantry, Udaya S.
dc.contributor.author Grześk, Grzegorz
dc.contributor.author Fabiszak, Tomasz
dc.contributor.author Kubica, Aldona
dc.contributor.author Świątkiewicz, Iwona
dc.contributor.author Bliden, Kevin P.
dc.contributor.author Gurbel, Paul Alfred
dc.date.accessioned 2013-02-21T13:12:49Z
dc.date.available 2013-02-21T13:12:49Z
dc.date.issued 2013-02-21
dc.identifier.issn 1897-5593
dc.identifier.uri http://repozytorium.umk.pl/handle/item/376
dc.description.abstract Abstract 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. (Cardiol J 2012; 19, 3:230 242)
dc.language.iso eng
dc.relation.ispartofseries Cardiology Journal 2012, Vol.19, No 3, pp 230-242;
dc.rights info:eu-repo/semantics/openAccess
dc.subject intracoronary abciximab
dc.subject myocardial infarction
dc.subject primary PCI
dc.title Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized clinical trials
dc.type info:eu-repo/semantics/article

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