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Intracoronary versus intravenous administration of abciximab in patients with acute coronary syndrome: a meta-analysis.

Wang JN, Diao S, Tang YJ, Hou AJ, Yuan HB, Zheng Y, Zhou YH - PLoS ONE (2013)

Bottom Line: However, the effect of intracoronary (i.c.) administration of abciximab on cardiovascular events remains unclear when compared with intravenous (i.v.) therapy.No other significant differences were identified between the effect of i.c. abciximab administration and i.v. therapy.I.c. administration of abciximab can reduce the risk of major cardiovascular events, reinfarction, and congestive heart failure when compared with i.v. therapy.

View Article: PubMed Central - PubMed

Affiliation: Director of the Hospital, Shanghai Seventh People's Hospital, Shanghai, China.

ABSTRACT

Background: Abciximab is a widely used adjunctive therapy for acute coronary syndrome (ACS). However, the effect of intracoronary (i.c.) administration of abciximab on cardiovascular events remains unclear when compared with intravenous (i.v.) therapy.

Methodology and principal findings: We systematically searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases and reference lists of articles and proceedings of major meetings for obtaining relevant literature. All eligible trials included ACS patients who received either i.c. administration of abciximab or i.v. therapy. The primary outcome was major cardiovascular events, and secondary outcomes included total mortality, reinfarction, and any possible adverse events. Of 660 identified studies, we included 9 trials reporting data on 3916 ACS patients. Overall, i.c. administration of abciximab resulted in 45% reduction in relative risk for major cardiovascular events (RR; 95% confidence interval [CI], 24-60%), 41% reduction in RR for reinfarction (95% CI, 7-63%), and 44% reduction in RR for congestive heart failure relative to i.v. therapy (95% CI, 8-66%); however, compared to i.v. therapy, i.c. administration of abciximab had no effect on total mortality (RR, 0.69; 95% CI, 0.45-1.07). No other significant differences were identified between the effect of i.c. abciximab administration and i.v. therapy.

Conclusions/significance: I.c. administration of abciximab can reduce the risk of major cardiovascular events, reinfarction, and congestive heart failure when compared with i.v. therapy.

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Related in: MedlinePlus

Flow diagram of the literature search and trials selection process.
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Related In: Results  -  Collection


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pone-0058077-g001: Flow diagram of the literature search and trials selection process.

Mentions: We identified 660 articles from our initial electronic search, of which 644 were excluded during an initial review (title and abstract). We retrieved the full text for the remaining 16 articles, and 9 randomized controlled trials met the inclusion criteria (Figure 1 and Figure S1), which consisted of data from 3916 ACS patients. Table 1 summarizes the characteristics of these trials and the important baseline information of the included patients. The trials included in this study compared IC administration of abciximab with IV therapy. Five of these studies [11], [12], [19]–[21] compared IC to IV therapy in patients with ST-elevation myocardial infarction (STEMI), and the other 4 trials [5], [22]–[24] evaluated individuals with ACS. The mean age of the patients ranged from 57 to 68, the patient follow-up duration ranged from 1 to 12 months, and the number of patients included in each study ranged from 45 to 2065. The outcomes were major cardiovascular events available in 6 trials [5], [12], [19], [20], [22], [23], total mortality in 9 trials [5], [11], [12], [19]–[24], reinfarction in 7 trials [5], [11], [12], [19]–[22], TVR in 5 trials [5], [12], [19], [20], [22], cardiac death in 3 trials [11], [12], [23], congestive heart failure in 2 trials [11], [20], major bleeding in 4 trials [11], [19], [21], [22], and stroke in 2 trials [11], [23]. Although the included trials scarcely reported on the key indicators of trial quality, the quality of the trials was also assessed according to the pre-defined criteria using Jadad scores [14]. Overall, 3 trials [5], [11], [12] scored 4, 3 trials [20], [21], [23] scored 3, and the remaining 3 trials [19], [22], [24] scored 2.


Intracoronary versus intravenous administration of abciximab in patients with acute coronary syndrome: a meta-analysis.

Wang JN, Diao S, Tang YJ, Hou AJ, Yuan HB, Zheng Y, Zhou YH - PLoS ONE (2013)

Flow diagram of the literature search and trials selection process.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585408&req=5

pone-0058077-g001: Flow diagram of the literature search and trials selection process.
Mentions: We identified 660 articles from our initial electronic search, of which 644 were excluded during an initial review (title and abstract). We retrieved the full text for the remaining 16 articles, and 9 randomized controlled trials met the inclusion criteria (Figure 1 and Figure S1), which consisted of data from 3916 ACS patients. Table 1 summarizes the characteristics of these trials and the important baseline information of the included patients. The trials included in this study compared IC administration of abciximab with IV therapy. Five of these studies [11], [12], [19]–[21] compared IC to IV therapy in patients with ST-elevation myocardial infarction (STEMI), and the other 4 trials [5], [22]–[24] evaluated individuals with ACS. The mean age of the patients ranged from 57 to 68, the patient follow-up duration ranged from 1 to 12 months, and the number of patients included in each study ranged from 45 to 2065. The outcomes were major cardiovascular events available in 6 trials [5], [12], [19], [20], [22], [23], total mortality in 9 trials [5], [11], [12], [19]–[24], reinfarction in 7 trials [5], [11], [12], [19]–[22], TVR in 5 trials [5], [12], [19], [20], [22], cardiac death in 3 trials [11], [12], [23], congestive heart failure in 2 trials [11], [20], major bleeding in 4 trials [11], [19], [21], [22], and stroke in 2 trials [11], [23]. Although the included trials scarcely reported on the key indicators of trial quality, the quality of the trials was also assessed according to the pre-defined criteria using Jadad scores [14]. Overall, 3 trials [5], [11], [12] scored 4, 3 trials [20], [21], [23] scored 3, and the remaining 3 trials [19], [22], [24] scored 2.

Bottom Line: However, the effect of intracoronary (i.c.) administration of abciximab on cardiovascular events remains unclear when compared with intravenous (i.v.) therapy.No other significant differences were identified between the effect of i.c. abciximab administration and i.v. therapy.I.c. administration of abciximab can reduce the risk of major cardiovascular events, reinfarction, and congestive heart failure when compared with i.v. therapy.

View Article: PubMed Central - PubMed

Affiliation: Director of the Hospital, Shanghai Seventh People's Hospital, Shanghai, China.

ABSTRACT

Background: Abciximab is a widely used adjunctive therapy for acute coronary syndrome (ACS). However, the effect of intracoronary (i.c.) administration of abciximab on cardiovascular events remains unclear when compared with intravenous (i.v.) therapy.

Methodology and principal findings: We systematically searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases and reference lists of articles and proceedings of major meetings for obtaining relevant literature. All eligible trials included ACS patients who received either i.c. administration of abciximab or i.v. therapy. The primary outcome was major cardiovascular events, and secondary outcomes included total mortality, reinfarction, and any possible adverse events. Of 660 identified studies, we included 9 trials reporting data on 3916 ACS patients. Overall, i.c. administration of abciximab resulted in 45% reduction in relative risk for major cardiovascular events (RR; 95% confidence interval [CI], 24-60%), 41% reduction in RR for reinfarction (95% CI, 7-63%), and 44% reduction in RR for congestive heart failure relative to i.v. therapy (95% CI, 8-66%); however, compared to i.v. therapy, i.c. administration of abciximab had no effect on total mortality (RR, 0.69; 95% CI, 0.45-1.07). No other significant differences were identified between the effect of i.c. abciximab administration and i.v. therapy.

Conclusions/significance: I.c. administration of abciximab can reduce the risk of major cardiovascular events, reinfarction, and congestive heart failure when compared with i.v. therapy.

Show MeSH
Related in: MedlinePlus