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The Benefits of abciximab with clopidogrel for percutaneous coronary intervention Questioned

Primary findings from the Intracoronary Stenting and Antithrombotic Regimen-Rapid// Early Action for Coronary Treatment Trial (ISAR-REACT) has indicated that abciximab use in patients undergoing percutaneous coronary intervention (PCI) after pretreatment with 600 mg clopidogrel for less than 2 hours offered no clinically measurable benefit at 30 days.

The trial included 2159 patients undergoing PCI for stable or unstable angina without marked ST-segment changes or positive biomarkers, who were randomly assigned to receive abciximab or placebo. Results after a 1 year follow up indicated that death, myocardial infarction (MI), or target vessel revascularization occurred in 23.8% of patients randomly assigned to either treatment. The combination of death and MI also occurred similarly, at 6% in the abciximab group and 6.4% in the placebo group, as did death alone, at 2.1% and 2.4%, respectively. No trend towards benefits was seen in any patient subgroup analyzed.

Although data on platelet inhibition has suggested that antithrombotic protection with clopidogrel plus abciximab would be more effective than clopidogrel alone , the results of ISAR-REACT at both 30 days and 1 year, reveal that the expected difference in in vitro inhibition of platelet aggregation did not translate into a difference in the clinical outcomes between patients treated with one versus both agents say researchers .

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