Safety and efficacy of abciximab use in conjunction with intracoronary urokinase in patients requiring angioplasty

Abciximab decreases ischemic complications during angioplasty. Intracoronar y urokinase lyses intracoronary thrombus, We studied the combination of bot h drugs. Twenty-six consecutive patients with acute coronary syndromes and intracoronary thrombus underwent intervention with abciximab and intracoron ary urokinase, All received aspirin and IV heparin. The dose of abciximab w as a weight-adjusted bolus and a 12-hr infusion. The dose of urokinase was 250,000 to 633,000 units, Hemorrhagic complications were classified accordi ng to the TIMI study group. Hemoglobin and platelet counts were measured be fore and 12 and 48 hr after the procedure. Procedural success was achieved in 24 patients. There were no deaths or repeat interventions. No patient ha d a major bleeding complication. Only two had minor complications. One pati ent needed blood transfusion. None had a stroke or thrombocytopenia. The us e of abciximab and intracoronary urokinase in the presence of intracoronary thrombus is associated with encouraging efficacy and few complications. (C ) 2000 Wiley-Liss, Inc.