Intention-to-treat analysis revealed a 48% reduction in the primary composite endpoint of death, MI, or urgent revascularization at 30 days (5.8% with abciximab versus 11.2% with placebo) (73). The benefit of abciximab was evident as early as 7 days after randomization, at which point the incidence of death or MI was half that in the placebo group and the need for emergency revascularization was 25% less. When only the 89% of enrollees who actually received the study treatment were considered, the reduction in the 30-day combined endpoint with abciximab was 52% (4.9% versus 10.3% with placebo; P = 0.03) and the reduction in the need for urgent target vessel revascularization was a striking 68% (1.8% versus 5.6%, P = 0.03) (74). The difference in the need for emergency revascularization was independent of acute angiographic results, suggesting that passivation of the vessel wall by abciximab contributes to the prevention of recurrent ischemic events.
In patients who received the study treatment, the need for bailout stenting dunng primary angioplasty was reduced by 38% (11.5% with abciximab versus 18.3% with placebo; P = 0.03) (75). Among those who received the infusion for the entire 12-hour period, the effect of abciximab was even more pronounced; the need for bailout stenting was reduced by 41%, from 20.6% to 12.3% (P = 0.02). This effect probably stemmed from the prevention of platelet aggregation by abciximab at the site of balloon inflation.
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