Effect of abciximab on cardiac enzyme elevation after transluminal extraction atherectomy (TEC) in high-risk saphenous vein graft lesions: Comparisonwith a historical control group

Saphenous vein graft (SVG) intervention has been associated with an increas ed incidence of distal embolization. Long lesions and lesions associated wi th thrombus are particularly at increased risk. This study was performed to determine whether abciximab may decrease this risk in high risk SVG angiop lasty. From June 1994 to June 1998, 84 patients with at least one high risk factor, i.e., lesion length >20 mm or angiographic evidence of thrombus, u nderwent Transluminal extraction atherectomy (TEC) procedure followed by ba lloon dilatation or stenting. Of these 84 patients, 37 who had procedure af ter September 1995 underwent TEC with abciximab (Abciximab Group) and 47 wh o had their procedure before that date had TEC without abciximab thereby se rving as historic control (Non-Abciximab Group). All patients had normal pr e-procedure OK and CK-MB. Total creatine kinase (CK) and CK-MB were measure d every 8 hr post-procedure for 24 hr. Baseline demographics, angiographic characteristics, incidence of LV dysfunction and triple vessel disease were similar between the two groups. Graft age was similar between two groups ( 122 +/- 70 vs. 117 +/- 54 months). Graft diameter, pre and postprocedure pe rcent stenoses were not different between the two groups. Stents were used in 65% in the Abciximab group and 45% in Non-Abciximab group (P = 0.14). Th ere was no in-hospital repeat PTCA, urgent bypass surgery, or cardiac death . There was no difference between the two groups in regards to the incidenc e of any elevation of total CK (27% vs. 21.3%) or CK-MB (54% vs. 51%). When used in conjunction with TEC in treating high risk vein graft lesions, abc iximab did not reduce post procedure OK-MB elevation in this patient popula tion. Cathet Cardiovasc Intervent 2001;52:40-44. (C) 2001 Wiley-Liss, Inc.