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

摘要

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 patients with acute myocardial infarction (AMI) and with incomplete reperfusion 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 following criteria: (1) total occlusion of the infarct‐related artery, (2) PA within 12 h of symptom onset, (3) postprocedural diameter stenosis < 30%, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade 2. Echocardiographic examination was performed before and on Days 7 and 30 after PA. The study population was divided into two groups: Group 1 (usual care, n = 13) and 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/l, 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 than in Group 1, whereas LV ejection fraction was higher in Group 2 than in Group 1 (52.1 ± 7.8 vs. 42.1 ± 6.4, p < 0.01). At 1‐month, abciximab was the only independent predictor of wall motion recovery index by multiple regression analysis. Conclusions: Rescue use of abciximab may reduce the infarct size in patients with AMI and TIMI grade 2 flow after PA, which may improve the recovery of regional LV function.