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Aims: In the Intracoronary Stenting and Antithrombotic Regimen-Rapid Early Action for Coronary Treatment Trial, the use of abciximab in patients undergoing percutaneous coronary intervention(PCI) after pre-treatment with 600 mg clopidogrel for >2 h was associated with no clinically measurable benefit at 30 days. We assessed whether there was any clinical benefit from abciximab at 1 year follow-up. Methods and results: After pre-treatment with 600 mg clopidogrel, a total of 2159 patients undergoing PCI for stable or unstable angina without marked ST-segment shifts or positive biomarkers were randomly assigned to receive abciximab or placebo. The occurrence of the composite end point of death, myocardial infarction, or target vessel revascularization was assessed at 1 year after randomization. At 1 year, the composite endpoint occurred in 23.8% of the patients in each group[relative risk(RR), 1.01; 95% confidence interval(CI), 0.85-1.20; P=0.92]. The combined incidence of death and myocardial infarction was 6.0% in the abciximab group and 6.4% in the placebo group(RR, 0.94; 95% CI, 0.67-1.32; P=0.73). The mortality rate was 2.1% in the abciximab group and 2.4% in the placebo group(RR, 0.88; 95% CI, 0.50-1.54; P=0.66). No trend towards clinical benefit was observed with abciximab at 1 year in any subgroup analysed. Conclusion: In patients with a low-to-intermediate risk profile undergoing PCI after pre-treatment with a 600 mg clopidogrel for at least 2 h, the use of abciximab offers no additional clinical benefit at 1 year.
Aims: In the Intracoronary Stenting and Antithrombotic Regimen-Rapid Early Action for Coronary Treatment Trial, the use of abciximab in patients undergoing percutaneous coronary intervention (PCI) after pre-treatment with 600 mg clopidogrel for> 2 h was associated with no clinically measurable benefit at 30 days. We assessed whether there was any clinical benefit from abciximab at 1 year follow-up. Methods and results: After pre-treatment with 600 mg clopidogrel, a total of 2159 patients undergoing PCI for stable or unstable angina without marked ST- segment occurrence or positive biomarkers were randomly assigned to receive abciximab or placebo. The occurrence of the composite end point of death, myocardial infarction, or target vessel revascularization was assessed at 1 year after randomization. At 1 year, the composite endpoint occurred in 23.8% of the patients in each group [relative risk (RR), 1.01; 95% confidence interval (CI), 0.85-1.20; P = 0.92]. The combined incidence of death and myoca rdial infarction was 6.0% in the abciximab group and 6.4% in the placebo group (RR, 0.94; 95% CI, 0.67-1.32; P = 0.73). The mortality rate was 2.1% in the abciximab group and 2.4% in the placebo No trend towards clinical benefit was observed with abciximab at 1 year in any subgroup analysed. Conclusion: In patients with a low-to-intermediate risk profile for outgoing (RR, 0.88; 95% CI, 0.50-1.54; PCI after pre-treatment with a 600 mg clopidogrel for at least 2 h, the use of abciximab offers no additional clinical benefit at 1 year.