Background: Percutaneous coronary intervention (PCI) is a highly effective therapy for acute
ST-elevation myocardial infarction (STEMI). Adjunctive therapy with glycoprotein (GP)
IIb/IIIa inhibitor can result in increased patency and improved outcomes in STEMI patients,
with thrombus, undergoing PCI. The investigation of novel dosing and delivery strategies of
this therapy may help to further improve outcomes.
Study design: Intracoronary Abciximab With Clearway Catheter trial is a randomized,
open-label, multicenter, trial to evaluate the effect of an intracoronary (IC) bolus dose of
abciximab delivered using the ClearWay™RX catheter versus an intravenous bolus (IV) of
abciximab for STEMI with angiographically visible thrombus (Thrombus Grade > 2). All patients
in both arms will receive intravenous abciximab infusion following the PCI for 12 hours per
standard practice. A total of 150 patients will be randomized 1:1 to treatment of the culprit
artery with IC abciximab (75 subjects) or IV abciximab (75 subjects) in addition to an
infusion regimen of abciximab administered intravenously and initiated following PCI. The
primary endpoint chosen to evaluate this hypothesis is infarct size as assessed on Cardiac
Magnetic Resonance (CMR). Clinical outcomes will be assessed for each subject through
hospital discharge and at 30 day follow-up.
Sample size: The number of patients included in this study was based on the estimation of the
sample size needed to identify a statistically significant difference of the primary
end-points between the two groups. The investigators estimated that 75 patients would be
required in each study group to have a power of 80% to detect an absolute difference in the
infarct size resolution of 15% with a two-sided alpha value of 0.05.
Conclusion: The purpose of this study is to demonstrate that an IC bolus of abciximab
delivered with the ClearWay™RX catheter added to a post-PCI intravenous infusion regimen of
abciximab will result in significant additional clot resolution in vivo when compared with an
IV bolus of abciximab when added to a post PCI intravenous infusion regimen of abciximab. The
primary endpoint chosen to evaluate this hypothesis is infarct size as assessed on CMR.
Phase:
Phase 3
Details
Lead Sponsor:
Gennaro Sardella
Treatments:
Abciximab Antibodies, Monoclonal Immunoglobulin Fab Fragments