Benefits are confined to patients with elevated troponin levels.
Percutaneous coronary intervention (PCI) is an
established therapy for patients with non–ST segment elevation acute
coronary syndromes (NSTE
The primary endpoint was a composite of death, myocardial infarction, or urgent target vessel revascularization within 30 days. Overall, the endpoint occurred in significantly fewer abciximab recipients than placebo recipients (8.9% vs. 11.9%), yielding a 25% reduction in relative risk. In the subset of patients with elevated troponin levels, the relative risk for the primary endpoint was reduced by 29% in the abciximab group, whereas in patients without elevated troponin, risk did not differ significantly between the two groups. There were no significant differences between the abciximab and placebo groups in the risk for major bleeding (1.4% and 1.4%), the risk for minor bleeding (4.2% and 3.3%), and the need for transfusion (2.5% and 2.0%).
Comment: Platelet activation and aggregability are greatly increased in patients
— John A. Marx, MD, FAAEM, FACEP
Published in Journal Watch Emergency Medicine May 23, 2006
A et al. Abciximab in patients with acute coronary
syndromes undergoing percutaneous coronary
intervention after clopidogrel pretreatment: The
ISAR-REACT 2 randomized trial. JAMA 2006 Apr 5; 295:1531-8.