Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials

A. Michael Lincoff, Leroy A. Lenarz, George J. Despotis, Peter K. Smith, Joan E. Booth, Russell E. Raymond, Shelly K. Sapp, Catherine F. Cabot, James E. Tcheng, Robert M. Califf, Mark B. Effron, Eric J. Topol, Dean J. Kereiakes, John Paul Runyon, Thomas Kelly, George Timmis, Neal S. Kleiman, Jeffrey Kramer, David Talley, Frank I. NavettaPhillip Kraft, James Ferguson, Kevin Browne, James Blankenship, Russell Ivanhoe, Neal Shadoff, Mark Taylor, Gerald Gacioch, Eric Bates, H. A. Snyder, Theodore A. Bass, Philip Bear, Larry Hattel, H. Vernon Anderson, Bruce Hettleman, Paul S. Teirstein, Ian Sarembock, Charles J. Davidson, Frank V. Aguirre, Michael Azrin, Seth Worley, Jean Francois Marquis, Douglas J. Spriggs, Mark W. Weston, Barry S. George, Donald R. Ricci, Carl W. Hartman, Anthony Farah, Gary Sander, Bernard M. Reen, Richard Heuser, Timothy Larkin, Jeffrey Popma, Mark L. Sanz, Jeffrey Burton, Robert I.G. Brown, William J. French, Allan G. Adelman, Ronald Gottlieb, Spencer B. King, John Ducas, Judith S. Hochman, Blair J. O'Neill, Po Kee Cheung, Merril Knudtson, Joseph Samaha, Lloyd W. Klein, David Almond, Michael J. Rosenberg, Michael Unks, Eric Cohen, John C. Webb, Jean Francois Tanguay, Patrick S. Coleman, Mark Thompson, Alan Gradman, Steven Yakubov, Mark Tannenbaum, Mark Gonzalez, Richard Bach, Frank E. Cummins, Charles Lucore, Brent Muhlestein, Robert Chisholm, Michael Del Core

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Background. Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. Methods. Outcomes were assessed among 85 patients who required coronary artery bypass grafting operations after coronary intervention in two randomized placebo-controlled trials of abciximab. Comparisons were made between patients in the pooled placebo and abciximab groups. Results. The incidence of coronary surgical procedures was 2.17% and 1.28% among patients randomized to placebo and abciximab, respectively (p = 0.021). Platelet transfusions were administered to 32% and 52% of patients in the placebo and abciximab groups, respectively (p = 0.059). Rates of major blood loss were 79% and 88% in the placebo and abciximab groups, respectively (p = 0.27); transfusions of packed red blood cells or whole blood were administered in 74% and 80% of patients, respectively (p = 0.53). Surgical reexploration for bleeding was required in 3% and 12% of patients, respectively. Death and myocardial infarction tended to occur less frequently among patients who had received abciximab. Conclusions. Urgent coronary artery bypass grafting operations can be performed without an incremental increase in major hemorrhagic risk among patients on abciximab therapy. (C) 2000 by The Society of Thoracic Surgeons.

Original languageEnglish (US)
Pages (from-to)516-526
Number of pages11
JournalAnnals of Thoracic Surgery
Volume70
Issue number2
DOIs
StatePublished - Jan 1 2000

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Lincoff, A. M., Lenarz, L. A., Despotis, G. J., Smith, P. K., Booth, J. E., Raymond, R. E., Sapp, S. K., Cabot, C. F., Tcheng, J. E., Califf, R. M., Effron, M. B., Topol, E. J., Kereiakes, D. J., Runyon, J. P., Kelly, T., Timmis, G., Kleiman, N. S., Kramer, J., Talley, D., ... Del Core, M. (2000). Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials. Annals of Thoracic Surgery, 70(2), 516-526. https://doi.org/10.1016/S0003-4975(00)01343-6