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, A. Michael Lincoff, Jeffrey Kramer, David Talley & 108 others Frank I. Navetta, Phillip Kraft, James E. Tcheng, 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, Michael Azrin, 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, Seth Worley, 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, John Ducas, Jeffrey H. Kramer, J. David Talley, Allan G. Adelman, Neal S. Kleiman, Eric Cohen, A. Michael Lincoff, Jeffrey Burton, Thomas Kelly, John C. Webb, Michael Del Core, Jean Francois Tanguay, Gerald Timmis, Patrick S. Coleman, Blair J. O'Neill, David Almond, Ronald Gottlieb, Michael Azrin, James Blankenship, Phillip Kraft, Robert Brown, Ian Sarembock, Kevin Browne, Bernard Reen, Mark Thompson, Theodore A. Bass, Jean Francois Marquis, William French, Alan Gradman, Seth Worley, Steven Yakubov, Russell J. Ivanhoe, Mark Taylor, Mark Tannenbaum, Judith Hochman, Eric Bates, Mark Gonzalez, John Paul Runyon, James Tcheng, Richard Bach, Michael Azrin, Frank E. Cummins, John P. Runyon, Mark Sanz, Mark W. Weston, H. V. Anderson, Timothy Larkin, Michael J. Rosenberg, Carl Hartman, Charles Lucore, Brent Muhlestein, Gary Sander, Robert Chisholm, Michael Del Core

Research output: Contribution to journalArticle

63 Citations (Scopus)

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

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Hemorrhage
Placebos
Coronary Artery Bypass
Erythrocyte Transfusion
Platelet Transfusion
abciximab
Percutaneous Coronary Intervention
Emergencies
Randomized Controlled Trials
Myocardial Infarction
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Michael Lincoff, A., Lenarz, L. A., Despotis, G. J., Smith, P. K., Booth, J. E., Raymond, R. E., ... 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

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

In: Annals of Thoracic Surgery, Vol. 70, No. 2, 2000, p. 516-526.

Research output: Contribution to journalArticle

Michael Lincoff, A, Lenarz, LA, Despotis, GJ, Smith, PK, Booth, JE, Raymond, RE, Sapp, SK, Cabot, CF, Tcheng, JE, Califf, RM, Effron, MB, Topol, EJ, Kereiakes, DJ, Runyon, JP, Kelly, T, Timmis, G, Kleiman, NS, Lincoff, AM, Kramer, J, Talley, D, Navetta, FI, Kraft, P, Tcheng, JE, Ferguson, J, Browne, K, Blankenship, J, Ivanhoe, R, Shadoff, N, Taylor, M, Gacioch, G, Bates, E, Snyder, HA, Bass, TA, Bear, P, Hattel, L, Anderson, HV, Hettleman, B, Teirstein, PS, Sarembock, I, Davidson, CJ, Aguirre, FV, Azrin, M, Worley, S, Marquis, JF, Spriggs, DJ, Azrin, M, Weston, MW, George, BS, Ricci, DR, Hartman, CW, Farah, A, Sander, G, Reen, BM, Heuser, R, Larkin, T, Popma, J, Sanz, ML, Burton, J, Brown, RIG, French, WJ, Adelman, AG, Gottlieb, R, King, SB, Worley, S, Ducas, J, Hochman, JS, O'Neill, BJ, Cheung, PK, Knudtson, M, Samaha, J, Klein, LW, Almond, D, Rosenberg, MJ, Unks, M, Ducas, J, Kramer, JH, Talley, JD, Adelman, AG, Kleiman, NS, Cohen, E, Lincoff, AM, Burton, J, Kelly, T, Webb, JC, Del Core, M, Tanguay, JF, Timmis, G, Coleman, PS, O'Neill, BJ, Almond, D, Gottlieb, R, Azrin, M, Blankenship, J, Kraft, P, Brown, R, Sarembock, I, Browne, K, Reen, B, Thompson, M, Bass, TA, Marquis, JF, French, W, Gradman, A, Worley, S, Yakubov, S, Ivanhoe, RJ, Taylor, M, Tannenbaum, M, Hochman, J, Bates, E, Gonzalez, M, Runyon, JP, Tcheng, J, Bach, R, Azrin, M, Cummins, FE, Runyon, JP, Sanz, M, Weston, MW, Anderson, HV, Larkin, T, Rosenberg, MJ, Hartman, C, Lucore, C, Muhlestein, B, Sander, G, Chisholm, R & Del Core, M 2000, 'Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials', Annals of Thoracic Surgery, vol. 70, no. 2, pp. 516-526. https://doi.org/10.1016/S0003-4975(00)01343-6
Michael Lincoff, A. ; Lenarz, Leroy A. ; Despotis, George J. ; Smith, Peter K. ; Booth, Joan E. ; Raymond, Russell E. ; Sapp, Shelly K. ; Cabot, Catherine F. ; Tcheng, James E. ; Califf, Robert M. ; Effron, Mark B. ; Topol, Eric J. ; Kereiakes, Dean J. ; Runyon, John Paul ; Kelly, Thomas ; Timmis, George ; Kleiman, Neal S. ; Lincoff, A. Michael ; Kramer, Jeffrey ; Talley, David ; Navetta, Frank I. ; Kraft, Phillip ; Tcheng, James E. ; Ferguson, James ; Browne, Kevin ; Blankenship, James ; Ivanhoe, Russell ; Shadoff, Neal ; Taylor, Mark ; Gacioch, Gerald ; Bates, Eric ; Snyder, H. A. ; Bass, Theodore A. ; Bear, Philip ; Hattel, Larry ; Anderson, H. Vernon ; Hettleman, Bruce ; Teirstein, Paul S. ; Sarembock, Ian ; Davidson, Charles J. ; Aguirre, Frank V. ; Azrin, Michael ; Worley, Seth ; Marquis, Jean Francois ; Spriggs, Douglas J. ; Azrin, Michael ; Weston, Mark W. ; George, Barry S. ; Ricci, Donald R. ; Hartman, Carl W. ; Farah, Anthony ; Sander, Gary ; Reen, Bernard M. ; Heuser, Richard ; Larkin, Timothy ; Popma, Jeffrey ; Sanz, Mark L. ; Burton, Jeffrey ; Brown, Robert I G ; French, William J. ; Adelman, Allan G. ; Gottlieb, Ronald ; King, Spencer B. ; Worley, Seth ; Ducas, John ; Hochman, Judith S. ; O'Neill, Blair J. ; Cheung, Po Kee ; Knudtson, Merril ; Samaha, Joseph ; Klein, Lloyd W. ; Almond, David ; Rosenberg, Michael J. ; Unks, Michael ; Ducas, John ; Kramer, Jeffrey H. ; Talley, J. David ; Adelman, Allan G. ; Kleiman, Neal S. ; Cohen, Eric ; Lincoff, A. Michael ; Burton, Jeffrey ; Kelly, Thomas ; Webb, John C. ; Del Core, Michael ; Tanguay, Jean Francois ; Timmis, Gerald ; Coleman, Patrick S. ; O'Neill, Blair J. ; Almond, David ; Gottlieb, Ronald ; Azrin, Michael ; Blankenship, James ; Kraft, Phillip ; Brown, Robert ; Sarembock, Ian ; Browne, Kevin ; Reen, Bernard ; Thompson, Mark ; Bass, Theodore A. ; Marquis, Jean Francois ; French, William ; Gradman, Alan ; Worley, Seth ; Yakubov, Steven ; Ivanhoe, Russell J. ; Taylor, Mark ; Tannenbaum, Mark ; Hochman, Judith ; Bates, Eric ; Gonzalez, Mark ; Runyon, John Paul ; Tcheng, James ; Bach, Richard ; Azrin, Michael ; Cummins, Frank E. ; Runyon, John P. ; Sanz, Mark ; Weston, Mark W. ; Anderson, H. V. ; Larkin, Timothy ; Rosenberg, Michael J. ; Hartman, Carl ; Lucore, Charles ; Muhlestein, Brent ; Sander, Gary ; Chisholm, Robert ; Del Core, Michael. / Abciximab and bleeding during coronary surgery : Results from the EPILOG and EPISTENT trials. In: Annals of Thoracic Surgery. 2000 ; Vol. 70, No. 2. pp. 516-526.
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title = "Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials",
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.",
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pages = "516--526",
journal = "Annals of Thoracic Surgery",
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TY - JOUR

T1 - Abciximab and bleeding during coronary surgery

T2 - Results from the EPILOG and EPISTENT trials

AU - Michael Lincoff, A.

AU - Lenarz, Leroy A.

AU - Despotis, George J.

AU - Smith, Peter K.

AU - Booth, Joan E.

AU - Raymond, Russell E.

AU - Sapp, Shelly K.

AU - Cabot, Catherine F.

AU - Tcheng, James E.

AU - Califf, Robert M.

AU - Effron, Mark B.

AU - Topol, Eric J.

AU - Kereiakes, Dean J.

AU - Runyon, John Paul

AU - Kelly, Thomas

AU - Timmis, George

AU - Kleiman, Neal S.

AU - Lincoff, A. Michael

AU - Kramer, Jeffrey

AU - Talley, David

AU - Navetta, Frank I.

AU - Kraft, Phillip

AU - Tcheng, James E.

AU - Ferguson, James

AU - Browne, Kevin

AU - Blankenship, James

AU - Ivanhoe, Russell

AU - Shadoff, Neal

AU - Taylor, Mark

AU - Gacioch, Gerald

AU - Bates, Eric

AU - Snyder, H. A.

AU - Bass, Theodore A.

AU - Bear, Philip

AU - Hattel, Larry

AU - Anderson, H. Vernon

AU - Hettleman, Bruce

AU - Teirstein, Paul S.

AU - Sarembock, Ian

AU - Davidson, Charles J.

AU - Aguirre, Frank V.

AU - Azrin, Michael

AU - Worley, Seth

AU - Marquis, Jean Francois

AU - Spriggs, Douglas J.

AU - Azrin, Michael

AU - Weston, Mark W.

AU - George, Barry S.

AU - Ricci, Donald R.

AU - Hartman, Carl W.

AU - Farah, Anthony

AU - Sander, Gary

AU - Reen, Bernard M.

AU - Heuser, Richard

AU - Larkin, Timothy

AU - Popma, Jeffrey

AU - Sanz, Mark L.

AU - Burton, Jeffrey

AU - Brown, Robert I G

AU - French, William J.

AU - Adelman, Allan G.

AU - Gottlieb, Ronald

AU - King, Spencer B.

AU - Worley, Seth

AU - Ducas, John

AU - Hochman, Judith S.

AU - O'Neill, Blair J.

AU - Cheung, Po Kee

AU - Knudtson, Merril

AU - Samaha, Joseph

AU - Klein, Lloyd W.

AU - Almond, David

AU - Rosenberg, Michael J.

AU - Unks, Michael

AU - Ducas, John

AU - Kramer, Jeffrey H.

AU - Talley, J. David

AU - Adelman, Allan G.

AU - Kleiman, Neal S.

AU - Cohen, Eric

AU - Lincoff, A. Michael

AU - Burton, Jeffrey

AU - Kelly, Thomas

AU - Webb, John C.

AU - Del Core, Michael

AU - Tanguay, Jean Francois

AU - Timmis, Gerald

AU - Coleman, Patrick S.

AU - O'Neill, Blair J.

AU - Almond, David

AU - Gottlieb, Ronald

AU - Azrin, Michael

AU - Blankenship, James

AU - Kraft, Phillip

AU - Brown, Robert

AU - Sarembock, Ian

AU - Browne, Kevin

AU - Reen, Bernard

AU - Thompson, Mark

AU - Bass, Theodore A.

AU - Marquis, Jean Francois

AU - French, William

AU - Gradman, Alan

AU - Worley, Seth

AU - Yakubov, Steven

AU - Ivanhoe, Russell J.

AU - Taylor, Mark

AU - Tannenbaum, Mark

AU - Hochman, Judith

AU - Bates, Eric

AU - Gonzalez, Mark

AU - Runyon, John Paul

AU - Tcheng, James

AU - Bach, Richard

AU - Azrin, Michael

AU - Cummins, Frank E.

AU - Runyon, John P.

AU - Sanz, Mark

AU - Weston, Mark W.

AU - Anderson, H. V.

AU - Larkin, Timothy

AU - Rosenberg, Michael J.

AU - Hartman, Carl

AU - Lucore, Charles

AU - Muhlestein, Brent

AU - Sander, Gary

AU - Chisholm, Robert

AU - Del Core, Michael

PY - 2000

Y1 - 2000

N2 - 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.

AB - 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.

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U2 - 10.1016/S0003-4975(00)01343-6

DO - 10.1016/S0003-4975(00)01343-6

M3 - Article

VL - 70

SP - 516

EP - 526

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 2

ER -