From the Division of Cardiology, Thoraxcenter, University Hospital
Dijkzigt, Erasmus University Rotterdam (P.K., S.M., M.L.S.), The Netherlands,
and the Data Processing Center Cardialysis B.V. (R.M., T.L.), Rotterdam, The
Netherlands.
Correspondence to A.P.J. Klootwijk, MD, Thoraxcenter Ba 316, Erasmus University Rotterdam, University Hospital Dijkzigt, PO Box 1738, 3000 DR Rotterdam, Netherlands.
Background—In the CAPTURE (c7E3
Fab Anti Platelet Therapy in Unstable REfractory angina) trial,
1265 patients with refractory unstable angina were treated with
abciximab or placebo, in addition to standard treatment from 16 to 24
hours preceding coronary intervention through 1 hour after
intervention. To investigate the incidence of recurrent
ischemia and the ischemic burden, a subset of 332
patients (26%) underwent continuous vector-derived 12-lead
ECG-ischemia monitoring.
Methods and Results—Patients were monitored from start of
treatment through 6 hours after coronary intervention.
Ischemic episodes were detected in 31 (18%) of the 169
abciximab and in 37 (23%) of the 163 placebo patients (NS). Only 9
(5%) of abciximab versus 22 (14%) of placebo patients had
Conclusions—Recurrent ischemia predicts MI or death
within 5 days of follow-up. Treatment with abciximab is
associated with a reduction of frequent ischemia and a
reduction of total ischemic burden in patients with refractory
unstable angina. As such, patients with ischemia derive
particularly high benefit from abciximab.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Reduction of Recurrent Ischemia With Abciximab During Continuous ECG-Ischemia Monitoring in Patients With Unstable Angina Refractory to Standard Treatment (CAPTURE)
2 ST
episodes (P<0.01). In patients with ischemia,
abciximab significantly reduced total ischemic burden
(P<0.02), which was calculated alternatively as the
total duration of ST episodes per patient, the area under the curve of
the ST vector magnitude during episodes, or the sum of the areas under
the curves of 12 leads during episodes. Twenty-one
patients (6%) suffered a myocardial infarction (MI) (18) or died (3)
within 5 days of treatment. The presence of asymptomatic
and symptomatic ST episodes during the monitoring period
preceding coronary intervention was associated with an
increased relative risk of these events of 3.2 (95% CI 1.4, 7.4) and
4.1 (95% CI 1.4, 12.2), respectively.
Key Words: platelet aggregation inhibitors • angina • ischemia • electrocardiography
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