ABSTRACT
Abciximab, a monoclonal antibody, is a potent intravenous blocker of the platelet glycoprotein
IIb=IIIa receptor. In addition to its antiplatelet effects, abciximab acts on other receptors, although the clinical significance of these effects is unclear. It has reduced ischemic events after
percutaneous coronary intervention (PCI), and its benefit applies to all interventional modalities
and all lesion types. It has decreased 1-year mortality, resulting in a high degree of cost-
effectiveness. The reduction in periprocedural ischemic events, as well as intermediate-term
mortality, is particularly robust in diabetic patients. Abciximab has been studied in the medical
management of non-ST-elevation acute coronary syndromes, with disappointing results and no
clear evidence of benefit. However, patients with acute coronary syndromes, when treated by
early revascularization, benefit greatly from abciximab. Abciximab, as an adjunct to balloon
angioplasty or stenting for acute ST-elevation myocardial infarction, improves outcomes.
Abciximab, in combination with fibrinolytic therapy, is being studied for acute myocardial
infarction; phase II studies have been promising, but phase III data are awaited. The study of
abciximab for acute stroke and limb ischemia, as well as an adjunct to carotid and peripheral
intervention, is in its infancy.
