BRAVE-3 Questions Value of Abciximab in PCI for Heart Attack

Sun Mar 30, 2008 9:00am EDT

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With high-dose clopidogrel, the intravenous anti-platelet drug appears

CHICAGO, March 30 /PRNewswire/ -- Over the years, interventional
cardiologists have made many improvements in percutaneous coronary
intervention (PCI) for patients with heart attack, among the most important,
refinements in the selection and administration of drugs that prevent unwanted
blood clotting. Now a new study has found that high loading doses of
clopidogrel, an oral medication that inhibits blood clots by preventing
platelets from clumping together, can eliminate the need for intravenous
abciximab, a standard cath-lab drug that also interferes with platelets, but
through a different pathway.
    The BRAVE-3 study is the first to test the influence of high-dose
clopidogrel on the value of abciximab exclusively in patients with
ST-elevation myocardial infarction (STEMI), a serious form of heart attack.
The study is being reported today in a Late-Breaking Clinical Trials session
at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit
(SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing
cardiovascular interventionalists sponsored by the Society for Cardiovascular
Angiography and Interventions (SCAI) in partnership with the American College
of Cardiology (ACC).
    "Acute myocardial infarction is a major medical problem, and the present
study will help to define the optimal treatment strategy," said Julinda
Mehilli, MD, an associate professor and staff cardiologist at Deutsches
Herzzentrum, Technical University, Munich, Germany. "Therapy without abciximab
would certainly be more cost-effective and reduce the risk of bleeding
    For the study Dr. Mehilli and colleagues recruited 800 patients with STEMI
who were undergoing PCI. All patients were pretreated with 600 mg of
clopidogrel and then randomly assigned to receive intravenous abciximab or a
placebo during the procedure.
    The study was designed primarily to compare how the two treatment
strategies affected the final amount of heart attack damage, as gauged by
blood flow in the heart muscle on a nuclear scan five to 10 days later. The
researchers found no difference between the two groups: The damage involved 10
percent of the left ventricle, on average, in the abciximab group and 9
percent of the left ventricle in the placebo group. In addition, the 30-day
combined rates of death, heart attack, stroke and urgent repeat coronary
procedures were similar in the two groups (5 percent and 3.8 percent,
    "For patients with acute ST-elevation myocardial infarction undergoing
primary coronary intervention after pre-treatment with a 600-mg loading dose
of clopidogrel, the additional use of abciximab is not associated with any
measurable benefit after 30 days," Dr. Mehilli said.
Dr. Mehilli will present the results of the BRAVE-3 study on Sunday, March
30 at 8:30 a.m. CDT in the Grand Ballroom, S100.
    About SCAI
    Headquartered in Washington, DC, the Society for Cardiovascular
Angiography and Interventions is a 4,000-member professional organization
representing invasive and interventional cardiologists in over 60 nations.
SCAI's mission is to promote excellence in invasive and interventional
cardiovascular medicine through physician education and representation, and
advancement of quality standards to enhance patient care. SCAI's annual
meeting has become the leading venue for education, discussion, and debate
about the latest developments in this dynamic medical specialty.
    About ACC
    The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is a 34,000-member
nonprofit medical society and bestows the credential Fellow of the American
College of Cardiology upon physicians who meet its stringent qualifications.
The College is a leader in the formulation of health policy, standards and
guidelines, and is a staunch supporter of cardiovascular research. The ACC
provides professional education and operates national registries for the
measurement and improvement of quality care.

Kathy Boyd David of SCAI, cell, +1-717-422-1181,; or Amy Murphy of
ACC, +1-202-375-6476, cell, +1-240-328-4549,
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