Use of abciximab prior to primary angioplasty in STEMI results in early recanalization of the infarct-related artery and improved myocardial tissue reperfusion -: results of the Austrian multi-centre randomized ReoPro-BRIDGING Study

Aims The aim of the ReoPro-BRIDGING Austrian multi-centre study was to investigate the effects of abciximab (ReoPro(R)) on early reperfusion in ST-elevation myocardial infarction prior to or during primary percutaneous coronary angioplasty (pPCI). Methods and results Fifty-five patients with STEMI were randomized either to start abciximab (0.25 mg/kg bolus followed by 10 mug/min infusion) during the organization phase for pPCI (Group 1, n = 28) or immediately before pPCI (Group 2, n = 27). The time between first bolus of abciximab and first balloon inflation of pPCI was 83 +/- 18 vs. 21 +/- 13 min in Group 1 vs 2. The pre-pPCI ST-segment resolution (55 +/- 21.4%, vs 42.4 +/- 18.2%, p = 0.005), TIMI flow grade 3 (29% vs 7%, p = 0.042), corrected TIMI frame count (58.4 +/- 32.7 vs 78.9 +/- 28.4 frame, p = 0.018) %diameter stenosis (76.3 /63.5-100/ vs 100 /73.5-100/; median /interquartile range/, p = 0.023), were significantly higher in Group 1 vs Group 2. Quantitative myocardial dye intensity measurement revealed a significantly higher grade of myocardial tissue perfusion (1 /0-9.25/ vs 0 / 0-3.0/ grey pixel unit, p = 0.048) in Group 1 before pPCI. Rapid release of cardiac enzymes was observed in Group 1 as compared with Group 2: rate of rise of CK was 210 +/- 209 vs 97 +/- 95 U/l/h (p = 0.015). QRS score indicated a smaller infarct size in Group 1 (4.8 +/- 3.8 vs 7.6 +/- 3.5, p = 0.011) on day 7. Conclusion The use of abciximab in the organization phase for pPCI results in signs of early recanalization of the infarct-related artery and a subsequent improved myocardial tissue reperfusion. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.