Beneficiary outcomes of abciximab in COVID-19 patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

Abstract

Background: SARS CoV2 pandemic affected the whole world with a high thrombotic burden during ST-segment elevation myocardial infarction (STEMI of the acute coronary syndrome. Meta-analysis and previous data have shown about GP2b3a inhibitor (Abciximab) has short and long-term efficacy in patients with STEMI undergoing PCI with high thrombotic burden.

Objectives: It was performed to verify the short-term & long-term efficacy and safety of abciximab in patients with STEMI undergoing percutaneous coronary intervention (PCI) during the COVID-19 era. 

Method: We conducted a multicentre cross-sectional observational study in north India among 433 patients of ACS presented STEMI with SARS CoV2 RT PCR positive cases followed by PCI with DES drug-eluting stents.Meta-analysis and systematic review equated with or without abciximab in STEMI with PCI.We divided into two groups: A (with abciximab) n=197 and B (without abciximab) n=236 during PCI.

Result: Results found in group A versus B about significant differences in risk of 30 days mortality (RR 0.51, CI 0.13–1.95, p =0.034) but major bleeding (1.17, 0.63–1.71, p =0.042), and transfusion (1.21, 0.94–1.61,) between the two groups. However, there were significant differences in risk of mortality at 6 months (0.40, 0.14–0.66,p=0.034), and mortality at 12 months (0.43, 0.22–0.64,p=0.013). At the 12month follow up showed MACE rate (0.51, 0.43–0.72,p=0.023), recurrent myocardial infarction (0.54, 0.23–0.85, p=0.053), repeat revascularization (0.57, 0.33–0.81, p=0.041),minor bleeding (1.28, 1.12–1.44, p=0.051), and thrombocytopenia (1.84 1.30–2.07, p=0.048). 

Conclusion: The role of abciximab could lead to a lower risk of reinfarction, revascularization, and all-cause death but a higher risk of minor bleeding, and thrombocytopenia during COVID 19 era.