Abciximab suppresses the rise in levels of circulating inflammatory markers after percutaneous coronary revascularization

Background-Previous investigators have shown that systemic markers of infla mmation may be increased in patients with acute ischemic syndromes or after percutaneous coronary revascularization and that persistent elevation in t hese markers is predictive of excess risk of subsequent adverse cardiac eve nts. By virtue of its cross-reactivity with the glycoprotein IIb/IIIa, av b eta3, and alphaM beta2 receptors, abciximab may reduce inflammatory process es. Methods and Results-Assays for the inflammatory markers C-reactive protein, interleukin-6, and tumor necrosis factor-a were performed on serum samples obtained from 160 patients in a placebo-controlled, randomized trial of ab ciximab during angioplasty. Eighty patients each had received a placebo or abciximab bolus plus a 12-hour infusion. Serum samples were drawn at baseli ne (before revascularization), 24 to 48 hours after study drug administrati on, and 4 weeks after study drug administration. Between baseline and 24 to 48 hours, the increase in C-reactive protein was 32% less in patients rece iving abciximab than placebo (P=0.025); the rise in interleukin-6 levels wa s 76% less in the abciximab group (P <0.001); and the rise in tumor necrosi s factor-ct levels was 100% less with abciximab therapy (P=0.112). By 4 wee ks, most marker levels had returned to baseline, with no significant differ ences between placebo and abciximab groups. Conclusions-Systemic markers of inflammation increase in the first 24 to 48 hours after angioplasty, but the magnitude of that rise is diminished by p eriprocedural abciximab. Some of the long-term clinical benefit derived fro m this agent may be related to an anti-inflammatory effect.