The routine use of glycoprotein (Gp) IIb-IIIa inhibitor such as abciximab is not recommended by current ACC/AHA guideline (Class IIb, level of evidence of A). This may be partly due to potential increase of bleeding. Compared bolus injection followed by continuous infusion of Gp IIb-IIIa inhibitor, single bolus administration was proposed to decrease bleeding complication while maintaining decrease ischemic events. It was also reported that direct intracoronary injection of abciximab might be superior to intravenous injection regarding myocardial perfusion. Aspiration thrombectomy is regarded as important adjunctive therapy in the treatment of acute ST-elevation myocardial infarction (IIa, level of evidence of B). We hypothesized that combination of intracoronary abciximab bolus injection and aspiration thrombectomy might enhance adequate myocardial perfusion in patient with acute ST-elevation myocardial infarction. We will determine whether combination of intracoronary abciximab injection and aspiration thrombectomy is superior to each treatment only in terms of myocardial perfusion through index of microcirculatory resistance and cardiac magnetic resonance imaging.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
bolus injection of abciximab via intracoronary route single injection during primary PCI dosage : 0.25mg/kg
Aspiration thrombectomy via aspiration catheter
Both use of intracoronary abciximab and aspiration thrombectomy
Yonsei University Wonju College of Medicine, Wonju Christian Hospital
Wŏnju, South Korea
Index of microcirculatory resistance by fractional flow reserve (FFR)
Immediate measurement of Index of microcirculatory resistance
Time frame: 1 day
Microvascular obstruction by cardiac magnetic resonance
Microvascular obstruction by cardiac magnetic resonance
Time frame: 7 days
Final TIMI flow grades
immediate measurement after successful PCI
Time frame: 1 day
Final TMP grades
immediate measurement of Final TMP grades
Time frame: 1 day
ST-segment resolution on ECG
ST-segment resolution on ECG 90-minute after PCI
Time frame: 1 day
Peak troponin I level
Peak troponin I level during hospitalization
Time frame: 5 days
target vessel failure
1-month target vessel failure defined as a composite of death from cardiac causes, any MI (not clearly attributable to a non-target vessel), or clinically indicated target vessel revascularization (TLR)
Time frame: 1 month
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