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CLINICAL RESEARCH: INTERVENTIONAL CARDIOLOGY

The Clinical Results of a Platelet Glycoprotein IIb/IIIa Receptor Blocker (Abciximab: ReoPro)-Coated Stent in Acute Myocardial Infarction

Weon Kim, MD^_*, Myung Ho Jeong, MD, FACC, FAHA, FESC^_*,_*, Kye Hun Kim, MD^_*, Il Suk Sohn, MD^_*, Young Joon Hong, MD^_*, Hyung Wook Park, MD^_*, Ju Han Kim, MD^_*, Young Keun Ahn, MD, FACC^_*, Jeong Gwan Cho, MD, FACC^_*, Jong Chun Park, MD^_*, Dong Lyun Cho, PhD and Jung Chae Kang, MD^_*

^_* Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Chemical Engineering of Chonnam National University, Gwangju, Korea.

Manuscript received August 31, 2005; revised manuscript received October 10, 2005, accepted October 18, 2005.

^_* Reprint requests and correspondence: Dr. Myung Ho Jeong, Cardiac Catheterization Laboratory, Heart Center of Chonnam National University Hospital, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea. (Email: myungho{at}chollian.net).

OBJECTIVES: This study is a prospective randomized trial investigating clinical outcomes of patients with acute myocardial infarction (AMI) treated with abciximab (ReoPro)-coated stents.

BACKGROUND: Recently we have demonstrated that abciximab-coated stents have inhibitory effects in the prevention of coronary restenosis.

METHODS: Ninety-six patients with AMI were randomly allocated into two groups; group I received abciximab-coated stents (n = 48, 57.1 ± 12.0 years), and group II received bare metal control stents (n = 48, 58.4 ± 11.6 years).

RESULTS: At baseline, clinical characteristics, percent diameter stenosis, and minimal luminal diameter were no different between the two groups. One patient in group II had reinfarction and target lesion reintervention during hospital stay. Follow-up coronary angiography was obtained in 77.1% (37 of 48) in group I and 75.0% (36 of 48) in group II. Percent diameter stenosis and late loss were significantly lower in group I than group II (18.9 ± 5.54% vs. 37.9 ± 6.25%, p = 0.008; and 0.39 ± 0.29 mm vs. 0.88 ± 0.45 mm; p = 0.008, respectively). At follow-up intravascular ultrasound, intrastent lumen area and intrastent neointimal hyperplasia (NIH) area were 5.4 ± 1.8 mm² and 2.2 ± 1.5 mm², respectively, in group I and 4.3 ± 1.6 mm² and 3.4 ± 1.8 mm², respectively, in group II (p = 0.045). And, in-stent restenosis rate was lower in group I than group II (p = 0.011 and p = 0.008, respectively). During 1-year follow-up, two patients in group II (4.1%) had AMI, whereas no patient in group I suffered AMI. Target lesion revascularization and total major adverse cardiac events rates were relatively lower in group I compared with those in group II (10.4% [5 of 48] vs. 20.8% [10 of 48], p = 0.261, and 10.4% vs. 25.0%, p = 0.107, respectively).

CONCLUSIONS: Abciximab-coated stent implantation was safe and effective without stent thrombosis in AMI patients.

Abbreviations and Acronyms   AMI = acute myocardial infarction   DES = drug-eluting stent   IVUS = intravascular ultrasound   MACE = major adverse cardiac events   PCI = percutaneous coronary intervention   TIMI = Thrombolysis In Myocardial Infarction

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