Korean J Med.  2003 Sep;65(3):289-299.

Predictive factors for long-term survival after a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab; ReoPro(R)) in patients undergoing high-risk percutaneous coronary intervention in acute myocardial infarction

• Kim W
• Chung EA
• Jeong MH
• Lim JH
• Kim HG
• Park HW
• Hong YJ
• Park OY
• Kim JH
• Ahn YK
• Cho JG
• Park JC
• Kang JC

Abstract

BACKGROUND: High-risk percutaneous coronary interventions (PCI) are associated with high complication rate, low procedural success rate and high restenosis rate. we analyzed the predictive factors of major adverse cardiac events (MACE) after administration a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab; Reo-Pro(R)) in Korean patients with acute myocardial infarction (AMI) underwent high-risk PCI.
METHODS
One hundred twenty-seven AMI patients with 158 lesion sites were administered ReoPro(R) who underwent high-risk PCI out of 3,532 patients at Chonnam National University Hospital between March 1999 and December 2001. The patients were divided into two groups: 94 patients without major adverse cardiac event (MACE) (Group I, 60.0 +/- 10.2 years, 73 male), and 33 patients with MACE (Group II, 59.8 +/- 9.7 years, 26 male) during clinical follow-up of 25.2 +/- 10.4 months duration.
RESULTS
The primary success rate was 91.3% (116/127). Clinical follow-up was performed in 97.6% of patients. The MACE were developed in 33 cases (26.0%) composed of 8 deaths (6.3%) and 5 AMI (3.9%). There was no major bleeding after PCI. Prevalence of diabetes, target lesion artery, ACC/AHA types and inflammatory marker were not different between the two groups. The predictive factors of MACE by multiple logistic regression analysis were incidence of multi-vessel disease and Thrombolysis In Myocardial Infarction (TIMI) flow grade 0-1 after PCI in group II than in group I (p=0.036, 0.033, respectively).
CONCLUSION
Multi-vessel lesion and low TIMI flow after high-risk PCI were associated with MACE in AMI patients treated on ReoPro(R) during long-term clinical follow-up.

Keyword

Platelets; Receptor; Myocardial Infarction; Angioplasty

MeSH Terms

Angioplasty
Arteries
Blood Platelets*
Follow-Up Studies
Glycoproteins*
Hemorrhage
Humans
Incidence
Jeollanam-do
Logistic Models
Myocardial Infarction*
Percutaneous Coronary Intervention*
Prevalence
Glycoproteins