M. Singh et al., Effect of abciximab on the outcome of emergency coronary artery bypass grafting after failed percutaneous coronary intervention, MAYO CLIN P, 76(8), 2001, pp. 784-788
Citations number
15
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objective: To evaluate the outcome of coronary artery bypass grafting (CABG
) for failed percutaneous coronary intervention (PCI) in patients who had r
eceived abciximab.
Patients and Methods: In this retrospective study, we analyzed the records
of patients who had PCI at our institution between January 1994 and Decembe
r 1998 and identified those who had urgent or emergency CABG within 48 hour
s after PCI. CABG was performed for failed PCI in patients who had ongoing
ischemia, hemodynamic compromise, or both. These patients were categorized
into 2 groups depending on whether they had been given abciximab during PCI
. We compared blood product transfusion requirements, bleeding complication
s, and frequency of in-hospital adverse events of the 2 groups.
Results: Of 5636 patients who had PCI, 77 (1.4%) had urgent or emergency CA
BG within 48 hours, including 11 who were given abciximab (abciximab group)
during PCI and 66 who were not given abciximab (no abciximab group). The 2
groups had similar baseline characteristics. The mean SD time to surgery w
as 8.4 +/-8.0 hours (median, 6 hours) for the abciximab group vs 12.1 +/- 1
2.5 hours (median, 4 hours) for the no abciximab group. Major bleeding (Thr
ombolysis in Myocardial Infarction criteria) occurred in 9 (90%) of 10 pati
ents in the abciximab group vs 48 (77%) of 62 patients in the no abciximab
group. The total volumes of intraoperative autotransfusion and transfusion
of red blood cells and fresh frozen plasma tended to be higher for the abci
ximab group. Also, this group received a mean of 13.9 U of platelets vs 3.2
U for the no abciximab group (P < .001). However, no in-hospital deaths oc
curred among patients in the abciximab group, and adverse events were infre
quent and comparable between the 2 groups. No difference was noted between
the 2 groups in the frequency of surgical reexploration for bleeding.
Conclusion: Transfusion requirements are higher for patients who undergo em
ergency or urgent CABG after having received abciximab during PCI. However,
in-hospital adverse events are infrequent and comparable to those for pati
ents who do not receive abciximab.