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®) 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 I¼g/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.