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(Circulation. 1999;100:e110.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Recovery of Coronary Flow and Left Ventricular Function After Abciximab

Koon-Hou Mak, MBBS

Department of Cardiology National Heart Centre, Tan Hospital, Singapore

	Introduction

 
To the Editor:

I read with great interest the article by Neumann et al¹ on the "Effect of Glycoprotein IIb/IIIa Receptor Blockade on Recovery of Coronary Flow and Left Ventricular Function After the Placement of Coronary-Artery Stents in Acute Myocardial Infarction." In particular, the recovery of coronary flow and left ventricular function provided by abciximab were related to improvement of perfusion of the coronary microvasculature beyond mere restoration of epicardial vessel patency. Indeed, the efficacy of abciximab in preventing distal embolization and reducing periprocedural myocardial infarction was observed previously among various subsets of patients in the EPIC (Evaluation of c7E3 for the Prevention of Ischemic Complications) trial.^{2 3}

In the article by Neumann et al,¹ patients with myocardial infarction were randomized to receiving standard-dose heparin or abciximab plus low-dose heparin. A total of 15 000 U was administered to those in the standard-heparin group compared with 30 000 U of heparin for those treated with abciximab plus low-dose heparin. In addition, patients in the standard-heparin group continued to receive heparin infusion for 12 hours after sheath removal. I suppose the total dose of heparin in the abciximab plus low-dose heparin group was 7500 U (typographical error in the text, I believe). Nonetheless, this dose is not particularly low, because the median dose among patients in the low-dose heparin group of the EPILOG (Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa blockade) study⁴ was 5500 U (interquartile range 4700 to 6600 U). On the other hand, the median doses . . . [Full Text of this Article]

Franz-Josef Neumann; MD Rudolf Blasini; MD Claus Schmitt; MD Eckhard Alt; MD Josef Dirschinger; MD Meinrad Gawaz; MD Adnan Kastrati; MD Albert Schömig, MD

Deutsches Herzzentrum and 1. Medizinische Klinik der Technischen Universität München, Munich, Germany

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