Abciximab and percutaneous coronary intervention: new indications. Medium-term benefit.

(1) Abciximab is now indicated for the prevention of ischaemic complications in patients undergoing percutaneous coronary intervention, and for the prevention of myocardial infarction in patients with unstable angina undergoing percutaneous coronary intervention. (2) The clinical file on abciximab now includes three placebo-controlled trials. (3) The EPIC trial involved patients at high risk of thrombosis, while the EPILOG trial included patients regardless of their risk of thrombosis. In neither trial did abciximab reduce overall mortality. In high-risk patients abciximab reduced the risk of a new myocardial infarction at one year, but not for longer. In patients at lower risk, the reduction in the risk of reinfarction persisted for at least six months. (4) The CAPTURE trial showed that abciximab, started 24 hours before angioplasty for unstable angina, reduced the risk of myocardial infarction at one month. (5) The bleeding risk was controlled by the use of heparin at doses adjusted to body weight, and by applying strict precautions to protect the injection site.