Prophylactic Abciximab in Elective Coronary Stenting: Results of a Randomized Trial


Corrado Tamburino, MD, Giovanni Russo, MD, Antonino Nicosia, MD,
Alfredo R. Galassi, MD, Rosario Foti, MD, V. Scriffignano, DSc, *Dean J. Kereiakes, MD, Giuseppe Giuffrida, MD

Study limitations. A possible drawback of this study is the method of angiographic analysis used. During recent years, the role of quantitative coronary arteriography in the trials analyzing restenosis has been widely recognized and the importance of achieving absolute values of luminal diameter has been underlined. However, even if we are aware of the limitations in accuracy that might derive from a “semiquantitative” analysis, we must emphasize that errors of measurement must be evenly distributed among the two groups (heparin and abciximab), since the reading of angiograms was blind to treatment. A larger cohort of patients would have been necessary to increase the statistical power of the study, and to clarify the direction of possible trends in outcome. The stent implantation procedure in this study was performed without intravascular ultrasound guidance. It cannot be determined whether the lack of such guidance might have resulted in sub-optimal stent expansion in some of our patients. However, randomization means that such occurrences must have been evenly distributed. This is a single-center study and there could have been bias reflecting local practices and prejudices.

Conclusion. Prophylactically administered adjunctive therapy with abciximab should be considered during percutaneous coronary interventions in patients with long lesions who may require the deployment of long or overlapping stents.

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