The aim of the ReoPro-BRIDGING Austrian multi-centre study was to investigate the effects of abciximab (ReoPro.) on early reperfusion in ST-elevation myocardial infarction prior to or during primary percutaneous coronary angioplasty(p-PCI). Fifty-five patients with STEMI were randomized either to start abciximab(0.25 mg/kg bolus followed by 10 μg/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. 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.
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