Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials

A. Michael Lincoff; Leroy A. Lenarz; George J. Despotis; Peter K. Smith; Joan E. Booth; Russell E. Raymond; Shelly K. Sapp; Catherine F. Cabot; James E. Tcheng; Robert M. Califf; Mark B. Effron; Eric J. Topol; Dean J. Kereiakes; John Paul Runyon; Thomas Kelly; George Timmis; Neal S. Kleiman; A. Michael Lincoff; Jeffrey Kramer; David Talley; Frank I. Navetta; Phillip Kraft; James E. Tcheng; James Ferguson; Kevin Browne; James Blankenship; Russell Ivanhoe; Neal Shadoff; Mark Taylor; Gerald Gacioch; Eric Bates; H. A. Snyder; Theodore A. Bass; Philip Bear; Larry Hattel; H. Vernon Anderson; Bruce Hettleman; Paul S. Teirstein; Ian Sarembock; Charles J. Davidson; Frank V. Aguirre; Michael Azrin; Seth Worley; Jean Francois Marquis; Douglas J. Spriggs; Michael Azrin; Mark W. Weston; Barry S. George; Donald R. Ricci; Carl W. Hartman; Anthony Farah; Gary Sander; Bernard M. Reen; Richard Heuser; Timothy Larkin; Jeffrey Popma; Mark L. Sanz; Jeffrey Burton; Robert I G Brown; William J. French; Allan G. Adelman; Ronald Gottlieb; Spencer B. King; Seth Worley; John Ducas; Judith S. Hochman; Blair J. O'Neill; Po Kee Cheung; Merril Knudtson; Joseph Samaha; Lloyd W. Klein; David Almond; Michael J. Rosenberg; Michael Unks; John Ducas; Jeffrey H. Kramer; J. David Talley; Allan G. Adelman; Neal S. Kleiman; Eric Cohen; A. Michael Lincoff; Jeffrey Burton; Thomas Kelly; John C. Webb; Donald R. Ricci; Jean Francois Tanguay; Gerald Timmis; Patrick S. Coleman; Blair J. O'Neill; David Almond; Ronald Gottlieb; Michael Azrin; James Blankenship; Phillip Kraft; Robert Brown; Ian Sarembock; Kevin Browne; Bernard Reen; Mark Thompson; Theodore A. Bass; Jean Francois Marquis; William French; Alan Gradman; Seth Worley; Steven Yakubov; Russell J. Ivanhoe; Mark Taylor; Mark Tannenbaum; Judith Hochman; Eric Bates; Mark Gonzalez; John Paul Runyon; James Tcheng; Richard Bach; Michael Azrin; Frank E. Cummins; John P. Runyon; Mark Sanz; Mark W. Weston; H. V. Anderson; Timothy Larkin; Michael J. Rosenberg; Carl Hartman; Charles Lucore; Brent Muhlestein; Gary Sander; Robert Chisholm; Michael Del Core

doi:10.1016/S0003-4975(00)01343-6

Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials

A. Michael Lincoff, Leroy A. Lenarz, George J. Despotis, Peter K. Smith, Joan E. Booth, Russell E. Raymond, Shelly K. Sapp, Catherine F. Cabot, James E. Tcheng, Robert M. Califf, Mark B. Effron, Eric J. Topol, Dean J. Kereiakes, John Paul Runyon, Thomas Kelly, George Timmis, Neal S. Kleiman, A. Michael Lincoff, Jeffrey Kramer, David TalleyFrank I. Navetta, Phillip Kraft, James E. Tcheng, James Ferguson, Kevin Browne, James Blankenship, Russell Ivanhoe, Neal Shadoff, Mark Taylor, Gerald Gacioch, Eric Bates, H. A. Snyder, Theodore A. Bass, Philip Bear, Larry Hattel, H. Vernon Anderson, Bruce Hettleman, Paul S. Teirstein, Ian Sarembock, Charles J. Davidson, Frank V. Aguirre, Michael Azrin, Seth Worley, Jean Francois Marquis, Douglas J. Spriggs, Michael Azrin, Mark W. Weston, Barry S. George, Donald R. Ricci, Carl W. Hartman, Anthony Farah, Gary Sander, Bernard M. Reen, Richard Heuser, Timothy Larkin, Jeffrey Popma, Mark L. Sanz, Jeffrey Burton, Robert I G Brown, William J. French, Allan G. Adelman, Ronald Gottlieb, Spencer B. King, Seth Worley, John Ducas, Judith S. Hochman, Blair J. O'Neill, Po Kee Cheung, Merril Knudtson, Joseph Samaha, Lloyd W. Klein, David Almond, Michael J. Rosenberg, Michael Unks, John Ducas, Jeffrey H. Kramer, J. David Talley, Allan G. Adelman, Neal S. Kleiman, Eric Cohen, A. Michael Lincoff, Jeffrey Burton, Thomas Kelly, John C. Webb, Donald R. Ricci, Jean Francois Tanguay, Gerald Timmis, Patrick S. Coleman, Blair J. O'Neill, David Almond, Ronald Gottlieb, Michael Azrin, James Blankenship, Phillip Kraft, Robert Brown, Ian Sarembock, Kevin Browne, Bernard Reen, Mark Thompson, Theodore A. Bass, Jean Francois Marquis, William French, Alan Gradman, Seth Worley, Steven Yakubov, Russell J. Ivanhoe, Mark Taylor, Mark Tannenbaum, Judith Hochman, Eric Bates, Mark Gonzalez, John Paul Runyon, James Tcheng, Richard Bach, Michael Azrin, Frank E. Cummins, John P. Runyon, Mark Sanz, Mark W. Weston, H. V. Anderson, Timothy Larkin, Michael J. Rosenberg, Carl Hartman, Charles Lucore, Brent Muhlestein, Gary Sander, Robert Chisholm, Michael Del Core

Research output: Contribution to journal › Article › peer-review

73 Scopus citations

Abstract

Background. Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. Methods. Outcomes were assessed among 85 patients who required coronary artery bypass grafting operations after coronary intervention in two randomized placebo-controlled trials of abciximab. Comparisons were made between patients in the pooled placebo and abciximab groups. Results. The incidence of coronary surgical procedures was 2.17% and 1.28% among patients randomized to placebo and abciximab, respectively (p = 0.021). Platelet transfusions were administered to 32% and 52% of patients in the placebo and abciximab groups, respectively (p = 0.059). Rates of major blood loss were 79% and 88% in the placebo and abciximab groups, respectively (p = 0.27); transfusions of packed red blood cells or whole blood were administered in 74% and 80% of patients, respectively (p = 0.53). Surgical reexploration for bleeding was required in 3% and 12% of patients, respectively. Death and myocardial infarction tended to occur less frequently among patients who had received abciximab. Conclusions. Urgent coronary artery bypass grafting operations can be performed without an incremental increase in major hemorrhagic risk among patients on abciximab therapy. (C) 2000 by The Society of Thoracic Surgeons.

Original language	English (US)
Pages (from-to)	516-526
Number of pages	11
Journal	Annals of Thoracic Surgery
Volume	70
Issue number	2
DOIs	https://doi.org/10.1016/S0003-4975(00)01343-6
State	Published - 2000

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine

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Michael Lincoff, A., Lenarz, L. A., Despotis, G. J., Smith, P. K., Booth, J. E., Raymond, R. E., Sapp, S. K., Cabot, C. F., Tcheng, J. E., Califf, R. M., Effron, M. B., Topol, E. J., Kereiakes, D. J., Runyon, J. P., Kelly, T., Timmis, G., Kleiman, N. S., Lincoff, A. M., Kramer, J., ... Del Core, M. (2000). Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials. Annals of Thoracic Surgery, 70(2), 516-526. https://doi.org/10.1016/S0003-4975(00)01343-6

Michael Lincoff, A, Lenarz, LA, Despotis, GJ, Smith, PK, Booth, JE, Raymond, RE, Sapp, SK, Cabot, CF, Tcheng, JE, Califf, RM, Effron, MB, Topol, EJ, Kereiakes, DJ, Runyon, JP, Kelly, T, Timmis, G, Kleiman, NS, Lincoff, AM, Kramer, J, Talley, D, Navetta, FI, Kraft, P, Tcheng, JE, Ferguson, J, Browne, K, Blankenship, J, Ivanhoe, R, Shadoff, N, Taylor, M, Gacioch, G, Bates, E, Snyder, HA, Bass, TA, Bear, P, Hattel, L, Anderson, HV, Hettleman, B, Teirstein, PS, Sarembock, I, Davidson, CJ, Aguirre, FV, Azrin, M, Worley, S, Marquis, JF, Spriggs, DJ, Azrin, M, Weston, MW, George, BS, Ricci, DR, Hartman, CW, Farah, A, Sander, G, Reen, BM, Heuser, R, Larkin, T, Popma, J, Sanz, ML, Burton, J, Brown, RIG, French, WJ, Adelman, AG, Gottlieb, R, King, SB, Worley, S, Ducas, J, Hochman, JS, O'Neill, BJ, Cheung, PK, Knudtson, M, Samaha, J, Klein, LW, Almond, D, Rosenberg, MJ, Unks, M, Ducas, J, Kramer, JH, Talley, JD, Adelman, AG, Kleiman, NS, Cohen, E, Lincoff, AM, Burton, J, Kelly, T, Webb, JC, Ricci, DR, Tanguay, JF, Timmis, G, Coleman, PS, O'Neill, BJ, Almond, D, Gottlieb, R, Azrin, M, Blankenship, J, Kraft, P, Brown, R, Sarembock, I, Browne, K, Reen, B, Thompson, M, Bass, TA, Marquis, JF, French, W, Gradman, A, Worley, S, Yakubov, S, Ivanhoe, RJ, Taylor, M, Tannenbaum, M, Hochman, J, Bates, E, Gonzalez, M, Runyon, JP, Tcheng, J, Bach, R, Azrin, M, Cummins, FE, Runyon, JP, Sanz, M, Weston, MW, Anderson, HV, Larkin, T, Rosenberg, MJ, Hartman, C, Lucore, C, Muhlestein, B, Sander, G, Chisholm, R & Del Core, M 2000, 'Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials', Annals of Thoracic Surgery, vol. 70, no. 2, pp. 516-526. https://doi.org/10.1016/S0003-4975(00)01343-6

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title = "Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials",

abstract = "Background. Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. Methods. Outcomes were assessed among 85 patients who required coronary artery bypass grafting operations after coronary intervention in two randomized placebo-controlled trials of abciximab. Comparisons were made between patients in the pooled placebo and abciximab groups. Results. The incidence of coronary surgical procedures was 2.17% and 1.28% among patients randomized to placebo and abciximab, respectively (p = 0.021). Platelet transfusions were administered to 32% and 52% of patients in the placebo and abciximab groups, respectively (p = 0.059). Rates of major blood loss were 79% and 88% in the placebo and abciximab groups, respectively (p = 0.27); transfusions of packed red blood cells or whole blood were administered in 74% and 80% of patients, respectively (p = 0.53). Surgical reexploration for bleeding was required in 3% and 12% of patients, respectively. Death and myocardial infarction tended to occur less frequently among patients who had received abciximab. Conclusions. Urgent coronary artery bypass grafting operations can be performed without an incremental increase in major hemorrhagic risk among patients on abciximab therapy. (C) 2000 by The Society of Thoracic Surgeons.",

author = "{Michael Lincoff}, A. and Lenarz, {Leroy A.} and Despotis, {George J.} and Smith, {Peter K.} and Booth, {Joan E.} and Raymond, {Russell E.} and Sapp, {Shelly K.} and Cabot, {Catherine F.} and Tcheng, {James E.} and Califf, {Robert M.} and Effron, {Mark B.} and Topol, {Eric J.} and Kereiakes, {Dean J.} and Runyon, {John Paul} and Thomas Kelly and George Timmis and Kleiman, {Neal S.} and Lincoff, {A. Michael} and Jeffrey Kramer and David Talley and Navetta, {Frank I.} and Phillip Kraft and Tcheng, {James E.} and James Ferguson and Kevin Browne and James Blankenship and Russell Ivanhoe and Neal Shadoff and Mark Taylor and Gerald Gacioch and Eric Bates and Snyder, {H. A.} and Bass, {Theodore A.} and Philip Bear and Larry Hattel and Anderson, {H. Vernon} and Bruce Hettleman and Teirstein, {Paul S.} and Ian Sarembock and Davidson, {Charles J.} and Aguirre, {Frank V.} and Michael Azrin and Seth Worley and Marquis, {Jean Francois} and Spriggs, {Douglas J.} and Michael Azrin and Weston, {Mark W.} and George, {Barry S.} and Ricci, {Donald R.} and Hartman, {Carl W.} and Anthony Farah and Gary Sander and Reen, {Bernard M.} and Richard Heuser and Timothy Larkin and Jeffrey Popma and Sanz, {Mark L.} and Jeffrey Burton and Brown, {Robert I G} and French, {William J.} and Adelman, {Allan G.} and Ronald Gottlieb and King, {Spencer B.} and Seth Worley and John Ducas and Hochman, {Judith S.} and O'Neill, {Blair J.} and Cheung, {Po Kee} and Merril Knudtson and Joseph Samaha and Klein, {Lloyd W.} and David Almond and Rosenberg, {Michael J.} and Michael Unks and John Ducas and Kramer, {Jeffrey H.} and Talley, {J. David} and Adelman, {Allan G.} and Kleiman, {Neal S.} and Eric Cohen and Lincoff, {A. Michael} and Jeffrey Burton and Thomas Kelly and Webb, {John C.} and Ricci, {Donald R.} and Tanguay, {Jean Francois} and Gerald Timmis and Coleman, {Patrick S.} and O'Neill, {Blair J.} and David Almond and Ronald Gottlieb and Michael Azrin and James Blankenship and Phillip Kraft and Robert Brown and Ian Sarembock and Kevin Browne and Bernard Reen and Mark Thompson and Bass, {Theodore A.} and Marquis, {Jean Francois} and William French and Alan Gradman and Seth Worley and Steven Yakubov and Ivanhoe, {Russell J.} and Mark Taylor and Mark Tannenbaum and Judith Hochman and Eric Bates and Mark Gonzalez and Runyon, {John Paul} and James Tcheng and Richard Bach and Michael Azrin and Cummins, {Frank E.} and Runyon, {John P.} and Mark Sanz and Weston, {Mark W.} and Anderson, {H. V.} and Timothy Larkin and Rosenberg, {Michael J.} and Carl Hartman and Charles Lucore and Brent Muhlestein and Gary Sander and Robert Chisholm and {Del Core}, Michael",

note = "Funding Information: Supported by Eli Lilly and Company (Indianapolis, IN) and Centocor, Inc (Malvern, PA). ",

year = "2000",

doi = "10.1016/S0003-4975(00)01343-6",

language = "English (US)",

volume = "70",

pages = "516--526",

journal = "Annals of Thoracic Surgery",

issn = "0003-4975",

publisher = "Elsevier",

number = "2",

}

TY - JOUR

T1 - Abciximab and bleeding during coronary surgery

T2 - Results from the EPILOG and EPISTENT trials

AU - Michael Lincoff, A.

AU - Lenarz, Leroy A.

AU - Despotis, George J.

AU - Smith, Peter K.

AU - Booth, Joan E.

AU - Raymond, Russell E.

AU - Sapp, Shelly K.

AU - Cabot, Catherine F.

AU - Tcheng, James E.

AU - Califf, Robert M.

AU - Effron, Mark B.

AU - Topol, Eric J.

AU - Kereiakes, Dean J.

AU - Runyon, John Paul

AU - Kelly, Thomas

AU - Timmis, George

AU - Kleiman, Neal S.

AU - Lincoff, A. Michael

AU - Kramer, Jeffrey

AU - Talley, David

AU - Navetta, Frank I.

AU - Kraft, Phillip

AU - Tcheng, James E.

AU - Ferguson, James

AU - Browne, Kevin

AU - Blankenship, James

AU - Ivanhoe, Russell

AU - Shadoff, Neal

AU - Taylor, Mark

AU - Gacioch, Gerald

AU - Bates, Eric

AU - Snyder, H. A.

AU - Bass, Theodore A.

AU - Bear, Philip

AU - Hattel, Larry

AU - Anderson, H. Vernon

AU - Hettleman, Bruce

AU - Teirstein, Paul S.

AU - Sarembock, Ian

AU - Davidson, Charles J.

AU - Aguirre, Frank V.

AU - Azrin, Michael

AU - Worley, Seth

AU - Marquis, Jean Francois

AU - Spriggs, Douglas J.

AU - Azrin, Michael

AU - Weston, Mark W.

AU - George, Barry S.

AU - Ricci, Donald R.

AU - Hartman, Carl W.

AU - Farah, Anthony

AU - Sander, Gary

AU - Reen, Bernard M.

AU - Heuser, Richard

AU - Larkin, Timothy

AU - Popma, Jeffrey

AU - Sanz, Mark L.

AU - Burton, Jeffrey

AU - Brown, Robert I G

AU - French, William J.

AU - Adelman, Allan G.

AU - Gottlieb, Ronald

AU - King, Spencer B.

AU - Worley, Seth

AU - Ducas, John

AU - Hochman, Judith S.

AU - O'Neill, Blair J.

AU - Cheung, Po Kee

AU - Knudtson, Merril

AU - Samaha, Joseph

AU - Klein, Lloyd W.

AU - Almond, David

AU - Rosenberg, Michael J.

AU - Unks, Michael

AU - Ducas, John

AU - Kramer, Jeffrey H.

AU - Talley, J. David

AU - Adelman, Allan G.

AU - Kleiman, Neal S.

AU - Cohen, Eric

AU - Lincoff, A. Michael

AU - Burton, Jeffrey

AU - Kelly, Thomas

AU - Webb, John C.

AU - Ricci, Donald R.

AU - Tanguay, Jean Francois

AU - Timmis, Gerald

AU - Coleman, Patrick S.

AU - O'Neill, Blair J.

AU - Almond, David

AU - Gottlieb, Ronald

AU - Azrin, Michael

AU - Blankenship, James

AU - Kraft, Phillip

AU - Brown, Robert

AU - Sarembock, Ian

AU - Browne, Kevin

AU - Reen, Bernard

AU - Thompson, Mark

AU - Bass, Theodore A.

AU - Marquis, Jean Francois

AU - French, William

AU - Gradman, Alan

AU - Worley, Seth

AU - Yakubov, Steven

AU - Ivanhoe, Russell J.

AU - Taylor, Mark

AU - Tannenbaum, Mark

AU - Hochman, Judith

AU - Bates, Eric

AU - Gonzalez, Mark

AU - Runyon, John Paul

AU - Tcheng, James

AU - Bach, Richard

AU - Azrin, Michael

AU - Cummins, Frank E.

AU - Runyon, John P.

AU - Sanz, Mark

AU - Weston, Mark W.

AU - Anderson, H. V.

AU - Larkin, Timothy

AU - Rosenberg, Michael J.

AU - Hartman, Carl

AU - Lucore, Charles

AU - Muhlestein, Brent

AU - Sander, Gary

AU - Chisholm, Robert

AU - Del Core, Michael

N1 - Funding Information: Supported by Eli Lilly and Company (Indianapolis, IN) and Centocor, Inc (Malvern, PA).

PY - 2000

Y1 - 2000

N2 - Background. Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. Methods. Outcomes were assessed among 85 patients who required coronary artery bypass grafting operations after coronary intervention in two randomized placebo-controlled trials of abciximab. Comparisons were made between patients in the pooled placebo and abciximab groups. Results. The incidence of coronary surgical procedures was 2.17% and 1.28% among patients randomized to placebo and abciximab, respectively (p = 0.021). Platelet transfusions were administered to 32% and 52% of patients in the placebo and abciximab groups, respectively (p = 0.059). Rates of major blood loss were 79% and 88% in the placebo and abciximab groups, respectively (p = 0.27); transfusions of packed red blood cells or whole blood were administered in 74% and 80% of patients, respectively (p = 0.53). Surgical reexploration for bleeding was required in 3% and 12% of patients, respectively. Death and myocardial infarction tended to occur less frequently among patients who had received abciximab. Conclusions. Urgent coronary artery bypass grafting operations can be performed without an incremental increase in major hemorrhagic risk among patients on abciximab therapy. (C) 2000 by The Society of Thoracic Surgeons.

AB - Background. Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. Methods. Outcomes were assessed among 85 patients who required coronary artery bypass grafting operations after coronary intervention in two randomized placebo-controlled trials of abciximab. Comparisons were made between patients in the pooled placebo and abciximab groups. Results. The incidence of coronary surgical procedures was 2.17% and 1.28% among patients randomized to placebo and abciximab, respectively (p = 0.021). Platelet transfusions were administered to 32% and 52% of patients in the placebo and abciximab groups, respectively (p = 0.059). Rates of major blood loss were 79% and 88% in the placebo and abciximab groups, respectively (p = 0.27); transfusions of packed red blood cells or whole blood were administered in 74% and 80% of patients, respectively (p = 0.53). Surgical reexploration for bleeding was required in 3% and 12% of patients, respectively. Death and myocardial infarction tended to occur less frequently among patients who had received abciximab. Conclusions. Urgent coronary artery bypass grafting operations can be performed without an incremental increase in major hemorrhagic risk among patients on abciximab therapy. (C) 2000 by The Society of Thoracic Surgeons.

UR - http://www.scopus.com/inward/record.url?scp=0033836321&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033836321&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(00)01343-6

DO - 10.1016/S0003-4975(00)01343-6

M3 - Article

C2 - 10969673

AN - SCOPUS:0033836321

SN - 0003-4975

VL - 70

SP - 516

EP - 526

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

IS - 2

ER -

Abciximab and bleeding during coronary surgery: Results from the EPILOG and EPISTENT trials

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