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
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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
