Drug Shrinks Cardiac Damage After Heart Attack

Infusing abciximab after a heart attack reduces the size of heart damage

(RxWiki News) Infusing anticoagulant drug ReoPro (abciximab) straight into the coronary artery appears to help reduce the amount of damage to the heart a month after a certain kind of heart attack.

The infusion takes place while a patient is receiving percutaneous coronary intervention (PCI) to open clogged arteries and also receiving a second blood thinner called Angiomax (bivalirudin).

"Remember that heart attack signs may vary by gender."

Dr. Gregg W. Stone, of Columbia University Medical Center and New York–Presbyterian Hospital, compared the drug infusion to use of a catheter to remove blood clots, which did not result in reduced damage to the heart muscle tissue.

During the study investigators enrolled 452 patients at 37 sites in six countries within four hours of a ST-elevation myocardial infarction (STEMI), a particular type of heart attack caused by a sudden and total blockage of a coronary artery, between November 2009 and December 2011. The patients were undergoing primary PCI and also taking anticoagulant bivalirudin.

Participants were randomly selected to bolus intracoronary abciximab delivered through a catheter to a damaged portion of the heart, or no abciximab and manual aspiration thrombectomy to remove blood clots, or no thrombectomy. Researchers assessed the amount of heart muscle that was damaged 30 days later through use of cardiac magnetic resonance imaging (cMRI).

Patients that received intracoronary abciximab compared to no abciximab were found to have a significant decrease in the amount of heart damage. This was measured as total myocardial mass, or the amount of viable heart muscle. Patients that received abciximab had 15.1 percent heart damage as compared to 17.9 percent in those that did not receive the drug.

Researchers found that patients who received aspiration thrombectomy as compared to those that did not had no significant difference in the size of heart damage.

The study was recently presented at the American College of Cardiology's annual scientific sessions, and also published in the Journal of the American Medical Association.

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Review Date: 
March 25, 2012