Intracoronary versus intravenous administration of abciximab in patients with acute coronary syndrome: a meta-analysis

• Published in: PloS one Vol. 8; no. 2; p. e58077
• Main Authors: Wang, Jie-Ning, Diao, Shu, Tang, Yuan-Jun, Hou, An-Ji, Yuan, Hai-Bo, Zheng, Yan, Zhou, Yu-Hao
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 28.02.2013; Public Library of Science (PLoS)
• Subjects: Abciximab; Acute Coronary Syndrome - drug therapy; Acute coronary syndromes; Administration, Intravenous; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal - therapeutic use; Atherosclerosis; Blood clots; Cardiovascular diseases; Clinical trials; Confidence intervals; Congestive heart failure; Coronary Vessels; Health risks; Heart; Heart attacks; Hospitals; Humans; Immunoglobulin Fab Fragments - administration & dosage; Immunoglobulin Fab Fragments - adverse effects; Immunoglobulin Fab Fragments - therapeutic use; Immunotherapy; Intravenous administration; Intravenous therapy; Lists; Medicine; Meta-analysis; Monoclonal antibodies; Mortality; Patients; Reduction; Risk reduction; Studies; Systematic review; Therapy; Treatment Outcome; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0058077

Abciximab is a widely used adjunctive therapy for acute coronary syndrome (ACS). However, the effect of intracoronary (i.c.) administration of abciximab on cardiovascular events remains unclear when compared with intravenous (i.v.) therapy. We systematically searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases and reference lists of articles and proceedings of major meetings for obtaining relevant literature. All eligible trials included ACS patients who received either i.c. administration of abciximab or i.v. therapy. The primary outcome was major cardiovascular events, and secondary outcomes included total mortality, reinfarction, and any possible adverse events. Of 660 identified studies, we included 9 trials reporting data on 3916 ACS patients. Overall, i.c. administration of abciximab resulted in 45% reduction in relative risk for major cardiovascular events (RR; 95% confidence interval [CI], 24-60%), 41% reduction in RR for reinfarction (95% CI, 7-63%), and 44% reduction in RR for congestive heart failure relative to i.v. therapy (95% CI, 8-66%); however, compared to i.v. therapy, i.c. administration of abciximab had no effect on total mortality (RR, 0.69; 95% CI, 0.45-1.07). No other significant differences were identified between the effect of i.c. abciximab administration and i.v. therapy. I.c. administration of abciximab can reduce the risk of major cardiovascular events, reinfarction, and congestive heart failure when compared with i.v. therapy.