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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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Effects of IC administration of abciximab on risk of total death as compared to IV therapy in patients with ACS.
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pone-0058077-g003: Effects of IC administration of abciximab on risk of total death as compared to IV therapy in patients with ACS.

Mentions: Data for the effect of IC administration of abciximab on total mortality were available from 9 trials [5], [11], [12], [19]–[24], including 3718 patients and 170 events of total mortality. Overall, IC abciximab administration reduced the risk of mortality by 31% but was not associated with a statistically significant reduction in the risk of mortality events (RR, 0.69; 95% CI, 0.45−1.07; Figure 3). We noted that there was some evidence of heterogeneity across the included studies; therefore, sensitivity analyses were performed to explore any possible intrinsic reason for this finding. We then excluded the trial of Thiele et al [11], which specifically included a large number of patients that may have contributed a large weight to the pooled conclusion. After this exclusion, we concluded that compared to IV therapy, IC administration of abciximab was associated with a reduction in the total mortality risk, which decreased by 46% (RR, 0.54; 95% CI, 0.36−0.81; Figure 3).


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)

Effects of IC administration of abciximab on risk of total death as compared to IV therapy in patients with ACS.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0058077-g003: Effects of IC administration of abciximab on risk of total death as compared to IV therapy in patients with ACS.
Mentions: Data for the effect of IC administration of abciximab on total mortality were available from 9 trials [5], [11], [12], [19]–[24], including 3718 patients and 170 events of total mortality. Overall, IC abciximab administration reduced the risk of mortality by 31% but was not associated with a statistically significant reduction in the risk of mortality events (RR, 0.69; 95% CI, 0.45−1.07; Figure 3). We noted that there was some evidence of heterogeneity across the included studies; therefore, sensitivity analyses were performed to explore any possible intrinsic reason for this finding. We then excluded the trial of Thiele et al [11], which specifically included a large number of patients that may have contributed a large weight to the pooled conclusion. After this exclusion, we concluded that compared to IV therapy, IC administration of abciximab was associated with a reduction in the total mortality risk, which decreased by 46% (RR, 0.54; 95% CI, 0.36−0.81; Figure 3).

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