One-year clinical outcomes with abciximab vs. placebo in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention after pre-treatment with clopidogrel: Results of the ISAR-REACT 2 randomized trial

Gjin Ndrepepa, Adnan Kastrati, Julinda Mehilli, Franz Josef Neumann, Jurriën Ten Berg, Olga Bruskina, Franz Dotzer, Melchior Seyfarth, Jürgen Pache, Josef Dirschinger, Peter B. Berger, Albert Schömig

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48 Scopus citations

Abstract

Aims: The aim of this study is to investigate whether the benefit of abciximab in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) undergoing percutaneous coronary intervention (PCI) after pre-treatment with 600 mg clopidogrel is sustained at 1 year. Methods and results: We performed 1-year follow-up of 2022 high-risk patients with NSTE-ACS undergoing urgent PCI, who were randomized to abciximab or placebo after pre-treatment with 600 mg clopidogrel in the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 2 trial. The combined incidence of death, myocardial infarction, or target vessel revascularization at 1 year was the primary outcome analysis. At 1 year, the primary outcome was reached in 23.3% of patients allocated to abciximab vs. 28.0% of patients allocated to placebo [relative risk (RR) 0.80, 95% confidence interval (CI) 0.67-0.95, P = 0.012]. The combined incidence of death or myocardial infarction was 11.6% in patients allocated to abciximab vs. 15.3% in patients allocated to placebo (RR 0.74, 95% CI 0.59-0.94, P = 0.015). Conclusion: In high-risk patients with NSTE-ACS undergoing a PCI after pre-treatment with 600 mg clopidogrel, adverse events occurred less frequently with abciximab and the early benefit was maintained at 1 year after administration.

Original languageEnglish
Pages (from-to)455-461
Number of pages7
JournalEuropean Heart Journal
Volume29
Issue number4
DOIs
StatePublished - Feb 2008

Keywords

  • Abciximab
  • Acute coronary syndrome
  • Clopidogrel
  • Percutaneous coronary intervention

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