Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT)
In the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT), abciximab reduced ischemic complications of stent implantation at 30 days and 6 months. The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ischemic complications by decreasing the in...
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| Veröffentlicht in: | The American journal of cardiology 2002-11, Vol.90 (9), p.916-921 |
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| container_title | The American journal of cardiology |
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| creator | Islam, M.Ashequl Blankenship, James C Balog, Craig Iliadis, Elias A Lincoff, A.Michael Tcheng, James E Califf, Robert M Topol, Eric J |
| description | In the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT), abciximab reduced ischemic complications of stent implantation at 30 days and 6 months. The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ischemic complications by decreasing the incidence of angiographic complications during coronary stenting. In EPISTENT, patients were randomized to stenting with abciximab (abciximab group), stenting with placebo (placebo group), or balloon angioplasty with abciximab. Angiographic complications (including major or minor dissection, distal embolization, thrombus postprocedure, side branch or other vessel occlusion, residual stenosis >50%, transient coronary occlusion, and Thrombolysis In Myocardial Infarction final flow 3 times normal with abciximab therapy (19.7% vs 24.5% in placebo group; p = 0.314). Abciximab (compared with placebo) significantly reduced the incidence of CK-MB elevation >3 times normal in those without any angiographic complications (6.5% vs 10.7%; p = 0.007). In summary, abciximab (compared with placebo) significantly reduced angiographic complications during coronary stenting. Abciximab also prevented CK-MB elevations in patients without angiographic complications. |
| doi_str_mv | 10.1016/S0002-9149(02)02653-X |
| format | Article |
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The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ischemic complications by decreasing the incidence of angiographic complications during coronary stenting. In EPISTENT, patients were randomized to stenting with abciximab (abciximab group), stenting with placebo (placebo group), or balloon angioplasty with abciximab. Angiographic complications (including major or minor dissection, distal embolization, thrombus postprocedure, side branch or other vessel occlusion, residual stenosis >50%, transient coronary occlusion, and Thrombolysis In Myocardial Infarction final flow <3) were recorded prospectively. Creatine kinase (CK)-MB enzyme levels after intervention were measured at 6-hour intervals. We analyzed angiographic complications and CK-MB elevations in the abciximab group (n = 784) and the placebo group (n = 803). Angiographic complications were 29% less frequent in the abciximab group compared with the placebo group (17.0% vs 23.8%; p = 0.001). In patients with angiographic complications, there was a nonsignificant reduction in the incidence of CK-MB elevation >3 times normal with abciximab therapy (19.7% vs 24.5% in placebo group; p = 0.314). Abciximab (compared with placebo) significantly reduced the incidence of CK-MB elevation >3 times normal in those without any angiographic complications (6.5% vs 10.7%; p = 0.007). In summary, abciximab (compared with placebo) significantly reduced angiographic complications during coronary stenting. Abciximab also prevented CK-MB elevations in patients without angiographic complications.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(02)02653-X</identifier><identifier>PMID: 12398954</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abciximab ; Angioplasty ; Angioplasty, Balloon, Coronary ; Antibodies, Monoclonal - therapeutic use ; Biological and medical sciences ; Blood Vessel Prosthesis Implantation ; Blood. Blood coagulation. Reticuloendothelial system ; Clinical trials ; Coronary Angiography - adverse effects ; Creatine Kinase - blood ; Creatine Kinase - drug effects ; Creatine Kinase, MB Form ; Double-Blind Method ; Drug Evaluation ; Endpoint Determination ; Female ; Humans ; Immunoglobulin Fab Fragments - therapeutic use ; Incidence ; Isoenzymes - blood ; Isoenzymes - drug effects ; Male ; Medical sciences ; Myocardial Ischemia - epidemiology ; Myocardial Ischemia - etiology ; Myocardial Ischemia - therapy ; North America - epidemiology ; Pharmaceuticals ; Pharmacology. Drug treatments ; Platelet Aggregation Inhibitors - therapeutic use ; Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use ; Stents ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>The American journal of cardiology, 2002-11, Vol.90 (9), p.916-921</ispartof><rights>2002 Excerpta Medica Inc.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Nov 1, 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-7f39c27cff24cc38d329504784d8a76136afb1df779bb245c02b1cd35501835b3</citedby><cites>FETCH-LOGICAL-c484t-7f39c27cff24cc38d329504784d8a76136afb1df779bb245c02b1cd35501835b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S000291490202653X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13993812$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12398954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Islam, M.Ashequl</creatorcontrib><creatorcontrib>Blankenship, James C</creatorcontrib><creatorcontrib>Balog, Craig</creatorcontrib><creatorcontrib>Iliadis, Elias A</creatorcontrib><creatorcontrib>Lincoff, A.Michael</creatorcontrib><creatorcontrib>Tcheng, James E</creatorcontrib><creatorcontrib>Califf, Robert M</creatorcontrib><creatorcontrib>Topol, Eric J</creatorcontrib><creatorcontrib>EPISTENT Investigators</creatorcontrib><title>Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>In the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT), abciximab reduced ischemic complications of stent implantation at 30 days and 6 months. The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ischemic complications by decreasing the incidence of angiographic complications during coronary stenting. In EPISTENT, patients were randomized to stenting with abciximab (abciximab group), stenting with placebo (placebo group), or balloon angioplasty with abciximab. Angiographic complications (including major or minor dissection, distal embolization, thrombus postprocedure, side branch or other vessel occlusion, residual stenosis >50%, transient coronary occlusion, and Thrombolysis In Myocardial Infarction final flow <3) were recorded prospectively. Creatine kinase (CK)-MB enzyme levels after intervention were measured at 6-hour intervals. We analyzed angiographic complications and CK-MB elevations in the abciximab group (n = 784) and the placebo group (n = 803). Angiographic complications were 29% less frequent in the abciximab group compared with the placebo group (17.0% vs 23.8%; p = 0.001). In patients with angiographic complications, there was a nonsignificant reduction in the incidence of CK-MB elevation >3 times normal with abciximab therapy (19.7% vs 24.5% in placebo group; p = 0.314). Abciximab (compared with placebo) significantly reduced the incidence of CK-MB elevation >3 times normal in those without any angiographic complications (6.5% vs 10.7%; p = 0.007). In summary, abciximab (compared with placebo) significantly reduced angiographic complications during coronary stenting. Abciximab also prevented CK-MB elevations in patients without angiographic complications.</description><subject>Abciximab</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Clinical trials</subject><subject>Coronary Angiography - adverse effects</subject><subject>Creatine Kinase - blood</subject><subject>Creatine Kinase - drug effects</subject><subject>Creatine Kinase, MB Form</subject><subject>Double-Blind Method</subject><subject>Drug Evaluation</subject><subject>Endpoint Determination</subject><subject>Female</subject><subject>Humans</subject><subject>Immunoglobulin Fab Fragments - therapeutic use</subject><subject>Incidence</subject><subject>Isoenzymes - blood</subject><subject>Isoenzymes - drug effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Myocardial Ischemia - epidemiology</subject><subject>Myocardial Ischemia - etiology</subject><subject>Myocardial Ischemia - therapy</subject><subject>North America - epidemiology</subject><subject>Pharmaceuticals</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use</subject><subject>Stents</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV1rFDEUhoModq3-BCUISnsxNh_zlSuRMupA0cKu0LuQZJLdlNlkm2SK_UP-TjO7qwVvvDqE87wn7zkvAK8x-oARri-WCCFSMFyyM0TOEakrWtw8AQvcNqzADNOnYPEXOQEvYrzNT4yr-jk4wYSyllXlAvzqjNEqQW-gkMr-tFshoXdQuLX16yB2G6ug8tvdaJVI1rsIhylYt4Y7HdSUhNN-ipkI3onwAGPSLs1t62DaaNjdi3HaC-cvrkeR9KgT7Ht50fe9gL3bWGn3_axY_lGvghUjPOuu--Wq-7Y6fwmeGTFG_epYT8GPz93q8mtx9f1Lf_npqlBlW6aiMZQp0ihjSKkUbQdKWIXKpi2HVjQ1prUwEg-maZiUpKwUIhKrgVYVwi2tJD0F7w9zd8HfTTomvrVR6XE87MkbUtN8VJzBt_-At34KLnvjhCLa0LokGaoOkAo-xqAN34V84PDAMeJzinyfIp8j4rnuU-Q3WffmOHySWz08qo6xZeDdERBRidEE4ZSNjxxljLZ4NvDxwOl8s3urA4_Kaqf0YENOnQ_e_sfKbybful4</recordid><startdate>20021101</startdate><enddate>20021101</enddate><creator>Islam, M.Ashequl</creator><creator>Blankenship, James C</creator><creator>Balog, Craig</creator><creator>Iliadis, Elias A</creator><creator>Lincoff, A.Michael</creator><creator>Tcheng, James E</creator><creator>Califf, Robert M</creator><creator>Topol, Eric J</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20021101</creationdate><title>Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT)</title><author>Islam, M.Ashequl ; Blankenship, James C ; Balog, Craig ; Iliadis, Elias A ; Lincoff, A.Michael ; Tcheng, James E ; Califf, Robert M ; Topol, Eric J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-7f39c27cff24cc38d329504784d8a76136afb1df779bb245c02b1cd35501835b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Abciximab</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Blood. Blood coagulation. Reticuloendothelial system</topic><topic>Clinical trials</topic><topic>Coronary Angiography - adverse effects</topic><topic>Creatine Kinase - blood</topic><topic>Creatine Kinase - drug effects</topic><topic>Creatine Kinase, MB Form</topic><topic>Double-Blind Method</topic><topic>Drug Evaluation</topic><topic>Endpoint Determination</topic><topic>Female</topic><topic>Humans</topic><topic>Immunoglobulin Fab Fragments - therapeutic use</topic><topic>Incidence</topic><topic>Isoenzymes - blood</topic><topic>Isoenzymes - drug effects</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Myocardial Ischemia - epidemiology</topic><topic>Myocardial Ischemia - etiology</topic><topic>Myocardial Ischemia - therapy</topic><topic>North America - epidemiology</topic><topic>Pharmaceuticals</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use</topic><topic>Stents</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Islam, M.Ashequl</creatorcontrib><creatorcontrib>Blankenship, James C</creatorcontrib><creatorcontrib>Balog, Craig</creatorcontrib><creatorcontrib>Iliadis, Elias A</creatorcontrib><creatorcontrib>Lincoff, A.Michael</creatorcontrib><creatorcontrib>Tcheng, James E</creatorcontrib><creatorcontrib>Califf, Robert M</creatorcontrib><creatorcontrib>Topol, Eric J</creatorcontrib><creatorcontrib>EPISTENT Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Islam, M.Ashequl</au><au>Blankenship, James C</au><au>Balog, Craig</au><au>Iliadis, Elias A</au><au>Lincoff, A.Michael</au><au>Tcheng, James E</au><au>Califf, Robert M</au><au>Topol, Eric J</au><aucorp>EPISTENT Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2002-11-01</date><risdate>2002</risdate><volume>90</volume><issue>9</issue><spage>916</spage><epage>921</epage><pages>916-921</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>In the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT), abciximab reduced ischemic complications of stent implantation at 30 days and 6 months. The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ischemic complications by decreasing the incidence of angiographic complications during coronary stenting. In EPISTENT, patients were randomized to stenting with abciximab (abciximab group), stenting with placebo (placebo group), or balloon angioplasty with abciximab. Angiographic complications (including major or minor dissection, distal embolization, thrombus postprocedure, side branch or other vessel occlusion, residual stenosis >50%, transient coronary occlusion, and Thrombolysis In Myocardial Infarction final flow <3) were recorded prospectively. Creatine kinase (CK)-MB enzyme levels after intervention were measured at 6-hour intervals. We analyzed angiographic complications and CK-MB elevations in the abciximab group (n = 784) and the placebo group (n = 803). Angiographic complications were 29% less frequent in the abciximab group compared with the placebo group (17.0% vs 23.8%; p = 0.001). In patients with angiographic complications, there was a nonsignificant reduction in the incidence of CK-MB elevation >3 times normal with abciximab therapy (19.7% vs 24.5% in placebo group; p = 0.314). Abciximab (compared with placebo) significantly reduced the incidence of CK-MB elevation >3 times normal in those without any angiographic complications (6.5% vs 10.7%; p = 0.007). In summary, abciximab (compared with placebo) significantly reduced angiographic complications during coronary stenting. Abciximab also prevented CK-MB elevations in patients without angiographic complications.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12398954</pmid><doi>10.1016/S0002-9149(02)02653-X</doi><tpages>6</tpages></addata></record> |
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| subjects | Abciximab Angioplasty Angioplasty, Balloon, Coronary Antibodies, Monoclonal - therapeutic use Biological and medical sciences Blood Vessel Prosthesis Implantation Blood. Blood coagulation. Reticuloendothelial system Clinical trials Coronary Angiography - adverse effects Creatine Kinase - blood Creatine Kinase - drug effects Creatine Kinase, MB Form Double-Blind Method Drug Evaluation Endpoint Determination Female Humans Immunoglobulin Fab Fragments - therapeutic use Incidence Isoenzymes - blood Isoenzymes - drug effects Male Medical sciences Myocardial Ischemia - epidemiology Myocardial Ischemia - etiology Myocardial Ischemia - therapy North America - epidemiology Pharmaceuticals Pharmacology. Drug treatments Platelet Aggregation Inhibitors - therapeutic use Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use Stents Survival Analysis Time Factors Treatment Outcome |
| title | Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT) |
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