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CLINICAL STUDIES

The influence of abciximab use on clinical outcome after aortocoronary vein graft interventions

^a Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

Manuscript received February 1, 1999; revised manuscript received May 4, 1999, accepted June 22, 1999.

Reprint requests and correspondence: Dr. Verghese Mathew, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905
mathew.verghese{at}mayo.edu

OBJECTIVES

The purpose of this study was to evaluate the effect of abciximab use on clinical outcome in aortocoronary vein graft interventions.

BACKGROUND

Although large randomized trials have demonstrated a significant benefit of abciximab use in the setting of percutaneous coronary interventions, there is relatively little data with respect to the use of this agent in percutaneous vein graft interventions.

METHODS

Three hundred and forty-three patients were identified; 210 undergoing vein graft intervention without abciximab and 133 patients with abciximab.

RESULTS

There were differences in baseline clinical and angiographic characteristics between the two groups; advanced age, unstable angina, older vein grafts and thrombus containing lesions were relatively common in both groups. Angiographic and procedural success rates were similar with or without the use of abciximab (89% vs. 92%, p = 0.15, and 85% vs. 91%, p = 0.12, respectively). The in-hospital composite end point of death/Q-wave myocardial infarction (QWMI)/repeat revascularization was similar between the two groups. Utilizing statistical modeling to adjust for baseline differences between the groups, abciximab use did not influence the cumulative long-term composite end point of death/MI/repeat revascularization.

CONCLUSIONS

This study demonstrates that in this relatively high-risk population undergoing aortocoronary vein graft interventions, the administration of abciximab periprocedurally does not appear to reduce major adverse clinical events.

Abbreviations and Acronyms   ACC/AHA = American College of Cardiology/American Heart Association   ACT = activated clotting time   CABG = coronary artery bypass grafting   CAPTURE = Chimeric 7E3 Antiplatelet in Unstable Angina Refractory to Standard Treatment   CI = confidence interval   CPK = creatine phosphokinase   EPIC = Evaluation of c7E3 in Preventing Ischemic Complications   EPILOG = Evaluation of PTCA to Improve Long-Term Outcomes by c7E3 Glycoprotein IIB/IIIA Receptor Blockade   MI = myocardial infarction   NQWMI = non-Q-wave myocardial infarction   OR = Odds ratio   PTCA = percutaneous transluminal coronary angioplasty   TIMI = Thrombolysis in Myocardial Infarction

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