0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Therapeutics |

Abciximab plus stenting reduced coronary events in patients with acute myocardial infarction

Allan D. Kitching, MD; and Robert Weiss, MD
[+] Article and Author Information

*See Glossary.

Sources of funding: Eli Lilly, Saint-Cloud, France, and Indianapolis, USA; and Saint-Côme-Chirurgie, Marseilles, France.

For correspondence: Dr. G. Montalescot, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France. E-mail gilles.montalescot@psl.ap-hop-paris.fr.


Ann Intern Med. 2002;136(3):89. doi:10.7326/ACPJC-2002-136-3-089
Text Size: A A A

Question: In patients with acute myocardial infarction (MI), is abciximab plus stenting more effective than placebo plus stenting for reducing coronary events?

Design: Randomized (unclear allocation concealment*), blinded (clinicians, patients, and outcome assessors),* placebo-controlled trial with 6-month follow-up.

Setting: 26 centers in France.

Patients: 300 patients (mean age 61 y, 82% men) who were > 18 years of age, had had the first symptoms of MI within 12 hours before enrollment, and had ST-segment elevation of > 1 mm in ≥ 2 contiguous electrocardiographic leads. Exclusion criteria were bleeding diathesis; administration of thrombolytic agents for the current episode; neoplasm; recent stroke; uncontrolled hypertension; recent surgery; oral anticoagulant therapy; limited life expectancy; child-bearing potential; and known contraindications to aspirin, ticlopidine, or heparin. Follow-up was 100%.

Intervention: 149 patients were allocated to abciximab (bolus of 0.25 mg/kg of body weight, followed by a 12-hour infusion of 0.125 µg/kg per min) plus stenting (the treatment group); 151 patients were allocated to placebo plus stenting (the control group).

Main outcome measures: The main outcome was a composite of death, reinfarction, or urgent revascularization of the target vessel at 30 days. The major secondary outcome was a composite of death, reinfarction, or any revascularization at 30 days and at 6 months.

Main results: Analysis was by intention to treat. At 30 days, the incidence of the composite end point of death, reinfarction, or urgent target-vessel revascularization and the incidence of the composite end point of death, reinfarction, or any revascularization were lower in the treatment than in the control group (Table). At 6 months, the incidence of the composite end point of death, reinfarction, or any revascularization was lower in the treatment than in the control group (Table).

Conclusion: In patients with acute myocardial infarction, abciximab plus stenting was more effective than placebo plus stenting for reducing coronary events.

Abciximab plus stenting vs placebo plus stenting for acute myocardial infarction†

OutcomesAbciximabPlaceboRRR (95% CI)NNT (CI)
Composite 1‡ at 30 d6%15%59% (15 to 80)12 (7 to 59)
Composite 2‡ at 30 d12%21%41% (1 to 65)12 (6 to 1421)
Composite 2 at 6 mo23%34%32% (3 to 53)10 (5 to 135)

†Abbreviations defined in Glossary; RRR, NNT, and CI calculated from data in article.

‡Composite 1 = death, reinfarction, or urgent target-vessel revascularization; composite 2 = death, reinfarction, or any revascularization.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)