TY - JOUR
T1 - Similar anti-inflammatory effects of intracoronary and intravenous Abciximab during primary percutaneous coronary intervention
T2 - a randomized study
AU - Secco, Gioel Gabrio
AU - Sansa, Mara
AU - Rognoni, Andrea
AU - Parisi, Rosario
AU - Fattori, Rossella
AU - Rossi, Lidia
AU - Lazzero, Maurizio
AU - Rolla, Roberta
AU - Bellomo, Giorgio
AU - Bongo, Angelo Sante
AU - Agostoni, Pierfrancesco
AU - Di Mario, Carlo
AU - Lupi, Alessandro
PY - 2015/3
Y1 - 2015/3
N2 - BackgroundIntracoronary Abciximab administration during primary percutaneous coronary intervention (pPCI) could offer theoretical advantages over the intravenous route. Besides antiplatelet effects, Abciximab can modulate inflammation via cross-reactivity with GPIIb/IIIa, avb3, and aMb2 receptors. The aim of our study was to assess whether the Abciximab administration route could influence its anti-inflammatory effects.MethodsEighty-nine consecutive ST elevation myocardial infarction patient candidates for pPCI were randomized to intracoronary (Group A-47 patients) or intravenous (Group B-42 patients) Abciximab bolus administration. The primary endpoint was the extent of inflammation, measured by C-reactive protein (CRP), vascular cell adhesion molecule 1 (VCAM-1) and inter-cellular adhesion molecule 1 (ICAM-1) levels. This study is registered with ClinicalTrials.gov, NCT01757457.ResultsData are expressed in medians (interquartiles). In both groups, troponin levels were similar [baseline: 0.12 (0.03-0.94) vs. 0.27 (0.07-1.24) ng/ml, P=0.73; postprocedural: 22.00 (14.75-69.43) vs. 31.96 (8.23-7.20) ng/ml, P=0.83]. Both groups also showed similar baseline [0.31 (0.14-0.69) vs. 0.22 (0.09-0.59) mg/ml, P=0.80] and postprocedural CRP levels [2.28 (1.37-4.23) vs. 2.16 (1.15-3.22) mg/dl, P=0.69], similar baseline [272.5 (224.7-340.8) vs. 262.2 (221.2-306.4) ng/ml, P=0.33] and postprocedural soluble ICAM-1 levels [281.5 (244.6-337.4) vs. 287.2 (226.9-359.2) ng/ml P=0.71], and similar baseline [771.6 (620.9-971.0) vs. 748.6 (592.2-838.8) ng/ml, P=0.30] and postprocedural soluble VCAM-1 levels [785.2 (671.6-947.1) vs. 745.9 (641.1-841.9) ng/ml, P=0.17]. In-hospital and 6-month event rates were similar in the two groups.ConclusionsOur study suggests that Abciximab has similar anti-inflammatory effects irrespective of the administration route. It is unlikely that the potential clinical benefits of intracoronary Abciximab can be related to modulation of integrin receptors.
AB - BackgroundIntracoronary Abciximab administration during primary percutaneous coronary intervention (pPCI) could offer theoretical advantages over the intravenous route. Besides antiplatelet effects, Abciximab can modulate inflammation via cross-reactivity with GPIIb/IIIa, avb3, and aMb2 receptors. The aim of our study was to assess whether the Abciximab administration route could influence its anti-inflammatory effects.MethodsEighty-nine consecutive ST elevation myocardial infarction patient candidates for pPCI were randomized to intracoronary (Group A-47 patients) or intravenous (Group B-42 patients) Abciximab bolus administration. The primary endpoint was the extent of inflammation, measured by C-reactive protein (CRP), vascular cell adhesion molecule 1 (VCAM-1) and inter-cellular adhesion molecule 1 (ICAM-1) levels. This study is registered with ClinicalTrials.gov, NCT01757457.ResultsData are expressed in medians (interquartiles). In both groups, troponin levels were similar [baseline: 0.12 (0.03-0.94) vs. 0.27 (0.07-1.24) ng/ml, P=0.73; postprocedural: 22.00 (14.75-69.43) vs. 31.96 (8.23-7.20) ng/ml, P=0.83]. Both groups also showed similar baseline [0.31 (0.14-0.69) vs. 0.22 (0.09-0.59) mg/ml, P=0.80] and postprocedural CRP levels [2.28 (1.37-4.23) vs. 2.16 (1.15-3.22) mg/dl, P=0.69], similar baseline [272.5 (224.7-340.8) vs. 262.2 (221.2-306.4) ng/ml, P=0.33] and postprocedural soluble ICAM-1 levels [281.5 (244.6-337.4) vs. 287.2 (226.9-359.2) ng/ml P=0.71], and similar baseline [771.6 (620.9-971.0) vs. 748.6 (592.2-838.8) ng/ml, P=0.30] and postprocedural soluble VCAM-1 levels [785.2 (671.6-947.1) vs. 745.9 (641.1-841.9) ng/ml, P=0.17]. In-hospital and 6-month event rates were similar in the two groups.ConclusionsOur study suggests that Abciximab has similar anti-inflammatory effects irrespective of the administration route. It is unlikely that the potential clinical benefits of intracoronary Abciximab can be related to modulation of integrin receptors.
KW - Abciximab
KW - inflammation
KW - primary percutaneous coronary intervention
KW - STEMI
KW - thrombosis
KW - ELEVATION MYOCARDIAL-INFARCTION
KW - IIB/IIIA RECEPTOR BLOCKADE
KW - LEUKOCYTE INTEGRIN MAC-1
KW - GLYCOPROTEIN IIB/IIIA
KW - BOLUS ABCIXIMAB
KW - CONTROLLED-TRIALS
KW - UNSTABLE ANGINA
KW - METAANALYSIS
KW - REVASCULARIZATION
KW - ANGIOPLASTY
U2 - 10.2459/JCM.0000000000000119
DO - 10.2459/JCM.0000000000000119
M3 - Article
C2 - 25022932
SN - 1558-2027
VL - 16
SP - 189
EP - 196
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
IS - 3
ER -