Effects of early abciximab administration before primary percutaneous coronary intervention on left ventricular function assessed by cardiac magnetic resonance.

BACKGROUND: It has been shown that early abciximab administration before primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) improves efficacy of treatment. However, there are no data on the impact of this strategy on left ventricular (LV) function during long-term follow-up.

AIM: To analyse the effects of early abciximab administration in patients with first anterior STEMI treated with pPCI on infarct size and LV function assessed by cardiac magnetic resonance.

METHODS: A total of 59 patients with STEMI, <12 hours from the chest pain onset, without cardiogenic shock, admitted to local hospitals without interventional facilities, with anticipated delay to pPCI <90 min were randomly assigned to two study groups: 27 patients received abciximab before transfer to the catheterisation laboratory (early abciximab group), and 32 patients received abciximab in the catheterisation laboratory just before pPCI (late abciximab group). All patients received aspirin and heparin (70 U/kg) before transfer to the cath lab. Clopidogrel loading dose was administered in the cath lab before angiography.

RESULTS: Cardiac magnetic resonance was performed in 14 patients from each study group 1 year after pPCI and revealed a significantly lower LV end-systolic volume index (p=0.003), end-diastolic volume index (p=0.009) and better ejection fraction (p <0.05) in patients who received abciximab early.

CONCLUSIONS: Early abciximab administration prior to transfer for pPCI in patients with first anterior STEMI results in a lower degree of LV remodelling and better LV ejection fraction at 1-year follow-up compared to late abciximab administration in the cath lab during pPCI.