***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: INTRODUCTION AND OBJECTIVES It has been clearly demonstrated that abciximab is useful in percutaneous coronary interventions . However , it is not known if intracoronary administration of the initial abciximab bolus improves outcome . Moreover , there may be safety concerns . METHODS The study was a single-center prospect i ve r and omized trial that included all patients undergoing coronary angioplasty involving the use of abciximab . Patients were r and omized to either intracoronary or intravenous administration of the abciximab bolus .  The primary endpoint was the incidence of major adverse cardiac events ( i.e. , death , myocardial infa rct ion , or the need for revascularization ) ; secondary endpoints were hemorrhagic complications and the troponin-I level . RESULTS The study included 137 patients ; 72 received an intracoronary abciximab bolus and 65 , an intravenous bolus . Clinical characteristics and baseline angiographic findings were similar in the two groups . All patients underwent coronary stent implantation . No difference was observed between the intracoronary bolus group and the intravenous bolus group in type of stent used ( drug eluting stent 47.2 % vs 50.8 % , respectively ) , total stent length , or final TIMI flow grade ( 3 vs 2.97 , respectively ) . The intervention success rates were also similar ( 98.5 % vs. 99 % , respectively ) . No complication associated with the administration route was reported . However , the level of the myocardial injury marker troponin I increased significantly in the intravenous bolus group . Clinical follow-up at 1 year did not reveal any difference in the incidence of major adverse cardiac events : 8.5 % in the intracoronary bolus group versus 6.2 % in the intravenous bolus group . CONCLUSIONS Intracoronary administration of an abciximab bolus did not appear to be less safe or effective than intravenous administration . Less post-procedural myocardial damage was observed in the intracoronary bolus group Background — Abciximab reduces major adverse cardiac events in patients with ST-elevation myocardial infa rct ion undergoing primary percutaneous coronary intervention ( PCI ) . Intracoronary abciximab bolus application results in high local drug concentrations and may be more effective than a st and ard intravenous bolus . Methods and Results — Patients undergoing primary PCI were r and omized to either  intracoronary ( n=77 )  or intravenous ( n=77 )  bolus abciximab administration with subsequent 12-hour intravenous infusion . The primary end point was infa rct size and extent of microvascular obstruction as assessed by delayed enhancement magnetic resonance . Secondary end points were ST-segment resolution at 90 minutes , Thrombolysis in Myocardial Infa rct ion flow and perfusion grade s after PCI , and the occurrence of major adverse cardiac events within 30 days . The median infa rct size was 15.1 % ( interquartile range , 6.1 % to 25.2 % ) in the intracoronary versus 23.4 % ( interquartile range , 13.6 % to 33.2 % ) in the intravenous group ( P=0.01 ) . Similarly , the extent of microvascular obstruction was significantly smaller in intracoronary compared with intravenous abciximab patients ( P=0.01 ) . Myocardial perfusion measured as early ST-segment resolution was significantly improved in intracoronary patients with an absolute ST-segment resolution of 77.8 % ( interquartile range , 66.7 % to 100.0 % ) versus 70.0 % ( interquartile range , 45.2 % to 83.5 % ; P=0.006 ) . The Thrombolysis in Myocardial Infa rct ion flow after PCI was not different between treatment groups ( P=0.51 ) , but there was a trend toward an improved perfusion grade ( P=0.09 ) . There also was a trend toward a lower major adverse cardiac event rate after intracoronary versus intravenous abciximab application ( 5.2 % versus 15.6 % ; P=0.06 ; relative risk , 0.33 ; 95 % CI , 0.09 to 1.05 ) . Conclusions — Intracoronary bolus administration of abciximab in primary PCI is superior to st and ard intravenous treatment with respect to infa rct size , extent of microvascular obstruction , and perfusion Background —In patients with acute myocardial infa rct ion or unstable angina undergoing coronary angioplasty , abciximab reduces major adverse cardiac events ( MACE ) . Clinical trials have studied intravenous administration only . Intracoronary bolus application of abciximab causes very high local drug concentrations and may be more effective . We studied whether intracoronary bolus administration of abciximab is associated with a reduced MACE rate compared with the st and ard intravenous bolus application . Methods and Results —We stratified 403 consecutive patients with acute myocardial infa rct ion or unstable angina undergoing coronary angioplasty according to the type of application of abciximab .  A 20-mg bolus of abciximab was given intravenously in 109 patients and intracoronarily in 294 patients . There were no differences between the groups with regard to diabetes mellitus , cardiogenic shock , successful intervention , or preprocedural and postprocedural TIMI flow . At 30 days , the incidence of MACE ( death , myocardial infa rct ion , urgent revascularization ) was significantly lower in the patients with intracoronary compared with intravenous administration of abciximab ( 10.2 % versus 20.2%;P < 0.008 ) , which was independent from stenting in multivariate analysis . The effect was most pronounced in patients with preprocedural TIMI 0/1 flow ( MACE : intracoronary 11.8 % versus intravenous 27.5 % , P < 0.002 ; n=273 ) . Conclusions —In patients with acute myocardial infa rct ion or unstable angina undergoing emergency coronary angioplasty , intracoronary bolus application of abciximab is associated with a reduction of MACE compared with the st and ard intravenous bolus application of abciximab . Prospect i ve , r and omized trials are warranted to further assess intracoronary application of abciximab BACKGROUND In the EASY trial , we have shown the clinical equivalence between abciximab bolus-only and abciximab bolus followed by 12-h infusion in a wide spectrum of patients after percutaneous coronary intervention ( PCI ) . Some reports have suggested better outcomes following intracoronary ( IC ) abciximab administration compared to intravenous ( IV ) delivery . We sought to compare cardiac biomarkers release and early and late clinical outcomes after IC or IV abciximab bolus delivery . METHODS From 1005 patients r and omized in the EASY trial and undergoing transradial coronary stent implantation , 208 received IC abciximab bolus and 797 received IV abciximab bolus . Route of administration was left to operators ' discretion . Creatine Kinase-MB , and Troponin-T ( Tn-T ) were obtained immediately prior to angiography , 4 - 6 h after PCI and the next day . MACE ( death , MI , TVR ) rate was evaluated at 30 days , 6 months and 12 months . RESULTS There were more patients with acute coronary syndrome  ( 75 % vs 64 % , P=0.004 ) and  previous MI ( 53 % vs 42 % , P=0.005 ) in the IC group and more patients with > or=3 dilated sites in the IV group ( 2 % IC vs 7 % IV , P=0.03 ) . After PCI , the extent of Tn-T and CK-MB release remained comparable in both groups . The MACE rate was 2 % in both groups at 30 days , 9 % in IC bolus vs 5 % in IV bolus ( P=0.04 ) at 6 months and 10 % in IC bolus vs 9 % in IV bolus ( P=0.50 ) at 12 months . By multivariate analysis , IC abciximab bolus was not associated with better outcomes at 12 months compared to IV bolus ( HR 1.07 , 95 % CI 0.82 - 1.35 , P=0.62 ) . CONCLUSION Compared to IV abciximab administration , IC abciximab was not associated with less cardiac biomarkers release or better clinical outcomes after uncomplicated transradial PCI . Further studies are required in clinical scenarios including patients with higher thrombotic burden and /or occluded vessels as in primary and rescue PCI There have been animal and human studies looking at intracoronary ( IC ) use of abciximab with good short‐term clinical outcomes . There exists no data comparing intracoronary with intravenous ( IV ) administration of abciximab beyond 30 days . We compared the clinical outcomes between the IC ( n = 101 ) and IV ( n = 72 ) group of patients . Patients who had coronary stenting and received abciximab were included in the study . All the patients received the st and ard systemic bolus dose of abciximab 0.25 mg/kg either via the IC or IV route , followed by a 12‐hr IV infusion at 0.125 μg/kg/min . The 6‐month composite endpoint of death or myocardial infa rct ion was slightly higher in the IV ( 13.9 % ) than in the IC group ( 5.9 % ; P = 0.04 ) . The frequency of bleeding complications was similar in both groups . The IC bolus route of abciximab may be superior to the intravenous route . Prospect i ve r and omized trials are warranted to vali date these findings . Catheter Cardiovasc Interv 2004;61:31–34 . © 2004 Wiley‐Liss , Background : Administration of glycoprotein IIb/IIIa inhibitors is an effective adjunctive treatment strategy during primary percutaneous coronary intervention ( PPCI ) for ST-segment elevation myocardial infa rct ion ( STEMI ) . Recent data suggest that an intracoronary administration of these drugs can increase the efficacy of PPCI . This study was done to find any potential difference in terms of efficacy of administering intracoronary Abciximab vs. intravenous Eptifibatide in primary PPCI . Methods : A total of 40 STEMI patients who underwent PPCI within 12 hours of symptom onset were r and omized to either an intracoronary Abciximab ( 0.25 μg/kg ) bolus or two boluses of intravenous Eptifibatide ( 0.180 μg/kg ) each 10 minutes . The primary end points were enzymatic infa rct size , myocardial reperfusion measured as ST-segment resolution ( STR ) , and post-procedural thrombolysis in myocardial infa rct ion ( TIMI ) grade flow of the infa rct -related artery . The secondary end points were intra-procedural adverse effect ( arrhythmia ) and no-reflow phenomenon , in-hospital mortality , reinfa rct ion , hemorrhage , and post-procedural global systolic function . Results : Post-procedural TIMI grade 3 flow was achieved in 95 % and 90 % of the intracoronary Abciximab and intravenous Eptifibatide groups , respectively ( p value = 0.61 ) . The infa rct size , as assessed by the area under the curve of creatine phosphokinase-MB in the first 48 hours after PPCI ( μmol/L/hr ) , was similar between the intracoronary Abciximab and intravenous Eptifibatide groups : 6591 ( interquartile range [ IQR ] , 3006.0 to 11112.0 ) versus 7,294 ( IQR , 3795.5 to 11803.5 ) ; p value = 0.59 . Complete STR was achieved in 55 % and 45 % of the intracoronary Abciximab and intravenous Eptifibatide groups , respectively ( p value = 0.87 ) . No deaths , urgent revascularizations , reinfa rct ions , or TIMI major bleeding events were observed in either group . Conclusion : The intracoronary administration of Abciximab was not superior to the intravenous administration of Eptifibatide in the STEMI patients who underwent primary PCI INTRODUCTION CD40 lig and has been suggested to play a pathogenic role in atherogenesis and coronary artery disease progression . Clinical studies suggest that intravenous ( IV ) abciximab administration attenuates the acute inflammatory response associated with percutaneous coronary intervention ( PCI ) . The anti-inflammatory effects of intracoronary ( IC ) versus IV administration of abciximab have not been systematic ally investigated . We assessed changes in soluble CD40 lig and ( sCD40L ) concentrations in response to IC versus IV abciximab in patients with ST-elevation myocardial infa rct ion ( STEMI ) undergoing thrombus-aspirating device during primary PCI . MET 
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Incidences of TVR , re-MI , major bleeding , stent thrombosis , and mortality showed no significant differences between the IC and IV groups .
Overall , the most appropriate route of administration of GP IIb/IIIa inhibitors for patients with acute coronary syndromes appeared to be an IC injection that could increase LVEF and TIMI 3 flow and decrease the incidence of HF .
Furthermore , the IC administration was not associated with increased adverse event rates when compared to IV injection