Meta-analysis of randomized controlled trials of intracoronary vs. intravenous administration of abciximab during percutaneous coronary intervention for ST-elevation myocardial infarction

AIM:To compare the effect of intracoronary (IC) vs. intravenous (IV) administration of abciximab during percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). METHODS: Published research was retrieved mainly from electronic databases (PubMed, EMBASE and the Cochrane Central Register of Controlled Trials). All randomized controlled trials comparing IC and IV administration of abciximab were included. RESULTS: A total of six randomized trials were included in the current meta-analysis, involving 1 138 patients. IC administration was more effective than IV administration of abciximab only in patients with thrombolysis in MI grade III flow ［RR=1.06, 95% CI(1.01, 1.12), P=0.02］. No statistically significant difference was found between the IC and IV groups according to the mortality rate ［RR=0.48, 95% CI(0.23, 1.02), P=0.06］, target vessel revascularization ［RR=0.55, 95% CI(0.30, 0.99), P=0.05］ and bleeding events ［RR=0.88, 95% CI(0.63, 1.23), P=0.44］. CONCLUSION: Compared with IV administration of abciximab, IC administration of abciximab improves myocardial reperfusion but does not reduce mortality rate, target vessel revascularization, or bleeding events in STEMI patients undergoing primary PCI.