Primary findings from the Intracoronary Stenting and Antithrombotic Regimen-Rapid Early Action for Coronary Treatment Trial (ISAR-REACT) has indicated that abciximab use in patients undergoing percutaneous coronary intervention (PCI) after pretreatment with 600 mg clopidogrel for less than 2 hours offered no clinically measurable benefit at 30 days.
The trial included 2159 patients undergoing PCI for stable or unstable angina without marked ST-segment changes or positive biomarkers, who were randomly assigned to receive abciximab or placebo. Results after a 1 year follow up indicated that death, myocardial infarction (MI), or target vessel revascularization occurred in 23.8% of patients randomly assigned to either treatment. The combination of death and MI also occurred similarly, at 6% in the abciximab group and 6.4% in the placebo group, as did death alone, at 2.1% and 2.4%, respectively. No trend towards benefits was seen in any patient subgroup analyzed.Although data on platelet inhibition has suggested that antithrombotic protection with clopidogrel plus abciximab would be more effective than clopidogrel alone , the results of ISAR-REACT at both 30 days and 1 year, reveal that the expected difference in in vitro inhibition of platelet aggregation did not translate into a difference in the clinical outcomes between patients treated with one versus both agents say researchers .
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