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Thorac Cardiovasc Surg 2006; 54(3): 150-156
DOI: 10.1055/s-2005-873067
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Bridge to Operation with the GPIIb/IIIa Inhibitor Abciximab in High-Risk Coronary Patients[1]

F. Schoenhoff1 , 6 , N. Kayhan1 , 6 , G. Thomas2 , K. K. Haase3 , M. Borggrefe3 , H. A. Katus4 , S. Hagl2 , C. F. Vahl1
  • 1Department of Thoracic and Cardiovascular Surgery, University of Mainz, Mainz, Germany
  • 2Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
  • 3Department of Cardiology, Reutlingen Hospital, Reutlingen, Germany
  • 4Department of Cardiology, University of Mannheim, Mannheim, Germany
  • 5Department of Cardiology, University of Heidelberg, Heidelberg, Germany
  • 6The authors contributed equally to this work.
Further Information

Publication History

Received June 8, 2005

Publication Date:
26 April 2006 (online)

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Abstract

Background: Glycoprotein-IIb/IIIa inhibitors are now frequently used in the cardiological treatment of high-risk coronary patients even if the patient is considered suitable for surgical intervention. However, there is no consensus whether GPIIb/IIIa inhibitors should be stopped before operation because of an increased risk of bleeding or if surgery should even be delayed until the anticoagulating effect subsides. Methods: From June 2002 to August 2003 140 patients who had to undergo primary aorto-coronary bypass for ongoing myocardial ischemia were enrolled in the present study. The patients received either clopidogrel, aspirin and heparin or additionally abciximab until operation. Results: Although the intraoperative need for blood products was higher in the abciximab group, there was no significant difference in postoperative blood loss. The hemodynamic situation of the abciximab patients after the operation was better compared to the other groups. 30-day mortality was not increased when compared to the elective control group (6.7 % vs. 6.1 %). Conclusion: The GPIIb/IIIa inhibitor abciximab can be safely used as a bridge to operation and results in a better hemodynamic outcome in high-risk coronary patients while reducing the incidence of major ischemic events.

Key words

GPIIb/IIIa inhibitors - abciximab - emergency CABG - EuroSCORE

1 Presented at the Annual Meeting of the German Society of Thoracic and Cardiovascular Surgery, Hamburg 2005

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1 Presented at the Annual Meeting of the German Society of Thoracic and Cardiovascular Surgery, Hamburg 2005

Dr. Nalan Kayhan

Klinik für Herz-, Thorax- und Gefäßchirurgie
Universität Mainz

Langenbeckstraße 1

55131 Mainz

Germany

Phone: + 496131175052

Fax: + 49 61 31 17 55 13

Email: kayhan.nalan@web.de