Abstract 14164: Intracoronary Compared with Intravenous Bolus Abciximab Application during Primary Percutaneous Coronary Intervention - 12 Month Follow-Up of the AIDA STEMI Trial
Background The AIDA STEMI trial compared i.c. versus i.v. abciximab bolus during primary PCI in ST-elevation myocardial infarction (STEMI) patients. At 90-day follow-up i.c. as compared to intravenous abciximab resulted in a similar 90-day rate of the primary composite clinical endpoint.1 However, there was a significant reduction in congestive heart failure. A longer follow-up is warranted. Here the 12-month data are reported.
Methods and Results AIDA STEMI was a randomised, open-label, multicenter trial. Patients presenting with STEMI were randomly assigned in a 1:1 ratio to i.c. versus i.v. abciximab bolus during PCI with subsequent 12 h intravenous infusion. The primary efficacy endpoint was the composite of all-cause mortality, recurrent infarction or new congestive heart failure within 90 days. Secondary clinical endpoints were each individual component and included also a 12-month follow-up. Between July 2008 to April 2011, 2065 patients were assigned to intracoronary (n=1032) or intravenous abciximab (n=1033). At 12-month follow-up i.c. as compared to i.v. abciximab resulted in a similar rate of the primary composite clinical endpoint (9.3% versus 9.7%; odds ratio 0.96; 95% CI 0.70-1.31; P=0.80). The incidence of death (5.5% versus 4.5%; odds ratio 1.26; 95% CI 0.82-1.91; P=0.29), reinfarction (2.9% versus 2.9%; odds ratio 0.99; 95% CI 0.58-1.71; P=0.99) did not differ between the treatment groups. At longer follow-up there was only a trend towards a lower rate of congestive heart failure in the i.c. versus i.v. group (2.9% versus 4.6%; odds ratio 0.63; 95% CI 0.38-1.03; P=0.06). Conclusion In STEMI patients undergoing primary PCI, intracoronary as compared to intravenous abciximab did not result in a difference in the combined endpoint of death, reinfarction or congestive heart failure at longer 12-month follow-up supporting the findings of the primary study endpoint at 90-day follow-up.
References: 1. Thiele H, Wöhrle J, Hambrecht R, et al. Intracoronary versus intravenous bolus abciximab during primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction: a randomised trial. Lancet. 2012;379:923-931.
- Platelet receptor blockers
- Glycoprotein iib/iiia platelet inhibitors
- Percutaneous coronary intervention
- © 2012 by American Heart Association, Inc.