Abstract | BACKGROUND: METHODS AND RESULTS: To evaluate whether potent platelet inhibition could reduce these complications, 60 patients with dynamic ST-T changes and recurrent pain despite intensive medical therapy were randomized to c7E3 Fab or placebo. After initial angiography had demonstrated a culprit lesion suitable for PTCA, placebo or c7E3 Fab was administered as 0.25 mg/kg bolus injection followed by 10 micrograms/min for 18 to 24 hours until 1 hour after completion of second angiography and PTCA. During study drug infusion, ischemia occurred in 9 c7E3 Fab and 16 placebo patients (P = .06). During hospital stay, 12 major events occurred in 7 placebo patients (23%), including 1 death, 4 infarcts, and 7 urgent interventions. In the c7E3 Fab group, only 1 event (an infarct) occurred (3%, P = .03). Angiography showed improved TIMI flow in 4 placebo and 6 c7E3 Fab patients and worsening of flow in 3 placebo patients but in none of the c7E3 Fab patients. Quantitative analysis showed significant improvement of the lesion in the patients treated with c7E3 Fab, which was not observed in the placebo group, although the difference between the two treatment groups was not significant. Measurement of platelet function and bleeding time demonstrated > 90% blockade of GPIIb/IIIa receptors, > 90% reduction of ex vivo platelet aggregation to ADP, and a significantly prolonged bleeding time during c7E3 Fab infusion, without excess bleeding. CONCLUSIONS:
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Authors | M L Simoons, M J de Boer, M J van den Brand, A J van Miltenburg, J C Hoorntje, G R Heyndrickx, L R van der Wieken, D de Bono, W Rutsch, T F Schaible |
Journal | Circulation
(Circulation)
Vol. 89
Issue 2
Pg. 596-603
(Feb 1994)
ISSN: 0009-7322 [Print] United States |
PMID | 7508826
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Immunoglobulin Fab Fragments
- Integrins
- Platelet Glycoprotein GPIIb-IIIa Complex
- Abciximab
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Topics |
- Abciximab
- Adult
- Aged
- Angina, Unstable
(diagnostic imaging, drug therapy, physiopathology)
- Angioplasty, Balloon, Coronary
- Antibodies, Monoclonal
(adverse effects, therapeutic use)
- Bleeding Time
- Coronary Angiography
- Female
- Humans
- Immunoglobulin Fab Fragments
(adverse effects, therapeutic use)
- Integrins
(antagonists & inhibitors)
- Male
- Middle Aged
- Myocardial Ischemia
(etiology)
- Platelet Function Tests
- Platelet Glycoprotein GPIIb-IIIa Complex
- Postoperative Complications
- Treatment Outcome
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