Rescue use of abciximab improves regional left ventricular function after early incomplete reperfusion in acute myocardial infarction

Background: Abciximab was shown to have important beneficial effects beyond the maintenance of epicardial coronary artery patency. However, it remains uncertain whether abciximab may lead to a better functional outcome in pat ients with acute myocardial infarction (AMI) and with incomplete reperfusio n after primary angioplasty (PA). Hypothesis: The study aimed to evaluate whether rescue use of abciximab may lead to a better functional outcome in such patients. Methods: The study included 25 patients with first AMI who met the followin g criteria: (1) total occlusion of the infarct-related artery, (2) PA withi n 12 h of Symptom onset, (3) postprocedural diameter stenosis < 30%, and fi nal Thrombolysis in Myocardial Infarction (TIMI) flow grade 2. Echocardiogr aphic examination was performed before and on Days 7 and 30 after PA. The s tudy population was divided into two groups: Group 1 (usual care, n = 13) a nd Group 2 (rescue use of abciximab, n = 12). Baseline characteristics were similar between the two groups. Results: Peak level of creatine kinase was higher in Group 1 than in Group 2 (5,800 +/- 2,700 vs. 3,800 +/- 2,000 U/1, p < 0.05). At 1 month follow-up , infarct zone wall motion score index (2.71 +/- 0.26 vs. 2.05 +/- 0.63, p < 0.01) and left ventricular (LV) volume indices were smaller in Group 2 th an in Group 1, whereas LV ejection fraction was higher in Group 2 than in G roup 1 (52.1 +/- 7.8 vs. 42. +/- 6.4, p < 0.01). At 1-month, abciximab was the only independent predictor of wall motion recovery index by multiple re gression analysis. Conclusions: Rescue use of abciximab may reduce the infarct size in patient s with AMI and TIMI grade 2 flow after PA, which may improve the recovery o f regional LV function.