***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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    ***EXAMPLES*** 
    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 Thrombosis has been implicated as central to the clinical complications of coronary angioplasty ( PTCA ) . Chimeric monoclonal 7E3 Fab ( c7E3 Fab ) is the first of a new class of antiplatelet drugs directed at the platelet glycoprotein IIb/IIIa integrin . This study was performed to determine the pharmacodynamics of c7E3 Fab administration during PTCA and to gain an initial clinical experience with this novel agent . METHODS AND RESULTS The study was a multicenter , open-label , dose-escalation study conducted in two stages . Enrollment included 56 patients scheduled for elective PTCA who were estimated to be at moderate to high risk of sustaining ischemic complications . All patients were given  aspirin and heparin . The study drug was given at least 10 minutes before PTCA . In stage 1 , increasing bolus doses of c7E3 Fab were given to 15 patients ; a bolus dose of 0.25 mg/kg was found to result in blockade of > 80 % of the receptors and reduce platelet aggregation to < 20 % compared with baseline , establishing this dose as that necessary to sufficiently suppress platelet activity . In stage 2 , additional c7E3 Fab was administered by continuous infusion to 32 patients for progressively longer periods of time ( up to 24 hours ) to confirm that platelet inhibition could be maintained with prolonged drug infusion . Also , 9 patients otherwise meeting entry criteria were given placebo . There were no thrombotic events among patients receiving c7E3 Fab .  Overall procedural and clinical success and complication rates as well as rates of bleeding were statistically similar among groups . However , minor bleeding was more frequent with administration of the active drug . CONCLUSIONS The novel antiplatelet agent c7E3 Fab can be administered during PTCA in combination with aspirin and heparin . Suppression of platelet activity is dose dependent and can be maintained for up to 24 hours . Further evaluation will be required to determine the extent of improvement in ischemic complication and restenosis rates and to provide additional insight into the safety profile of this potent monoclonal platelet antibody Background —Trials of platelet glycoprotein IIb/IIIa inhibitors as adjuncts to primary percutaneous coronary intervention for acute myocardial infa rct ion ( MI ) have shown improved early clinical and angiographic outcomes with treatment . However , variations in trial design s , modest sample sizes , and limited long-term follow-up have precluded these studies from being definitive . Methods and Results —As a prespecified secondary analysis of the CADILLAC trial , we compared early and late outcomes by abciximab assignment among 2082 patients r and omized in an open-label , 2 × 2 factorial- design trial of primary stenting versus angioplasty and abciximab treatment ( n=1052 ) versus no abciximab treatment ( n=1030 ) . Baseline characteristics were balanced between groups . Abciximab treatment was associated with a significant reduction in the composite end point of death , MI , ischemia-driven target-vessel revascularization ( TVR ) , or disabling stroke at 30 days ( 4.6 % versus 7.0 % ; relative risk , 0.65 ; 95 % CI , 0.46 to 0.93 ; P = 0.01 ) . Subacute thrombosis also was significantly reduced with abciximab treatment . At 12 months , however , rates of the composite end point did not differ significantly ( 18.4 % for controls versus 16.9 % for abciximab-treated patients ; relative risk , 0.92 ; 95 % CI , 0.76 to 1.10 ; P = 0.29 ) , reflecting a decrease in the relative difference in TVR rates ( ie , no effect of abciximab on reducing restenosis ) . In an angiographic sub study ( n=656 ) , myocardial salvage , restenosis , and infa rct -artery reocclusion at 7 months were unaffected by abciximab treatment . There was no significant interaction between stenting and abciximab treatment . Conclusions —Adjunctive abciximab treatment during primary percutaneous coronary intervention significantly enhanced 30-day event-free survival , predominantly by reducing ischemia-driven TVR  . Abciximab treatment did not affect the composite end point at 1 year , reflecting a lack of effect on restenosis Background —Diabetic patients are at increased risk of adverse outcomes after percutaneous coronary interventions . Although subset analyses suggest particular benefit from the administration of abciximab in diabetic patients , no dedicated large r and omized trials have been performed in diabetic patients undergoing percutaneous coronary intervention  , and certainly not after pretreatment with a high loading dose of clopidogrel . Methods and Results —This study ( Intracoronary Stenting and Antithrombotic Regimen : Is Abciximab a Superior Way to Eliminate Elevated Thrombotic Risk in Diabetics [ ISAR-SWEET ] Study ) enrolled 701 diabetic patients with coronary artery disease who underwent an elective percutaneous coronary intervention after pretreatment with a 600-mg dose of clopidogrel > 2 hours before the procedure : 351 patients were r and omly assigned to abciximab  and 350 patients to placebo . The primary end point of the trial was the composite incidence of death and myocardial infa rct ion at 1 year . The frequency of angiographic restenosis ( diameter stenosis ≥50 % ) was the secondary end point . The incidence of death or myocardial infa rct ion was 8.3 % in the abciximab group and 8.6 % in the placebo group ( P=0.91 ) , with a relative risk of 0.97 ( 95 % CI , 0.58 to 1.62 ) . The incidence of angiographic restenosis was 28.9 % in the abciximab group and 37.8 % in the placebo group ( P=0.01 ) , with a relative risk of 0.76 ( 95 % CI , 0.62 to 0.94 ) . The incidence of target lesion revascularization was 23.2 % in the abciximab group and 30.4 % in the placebo group ( P=0.03 ) . Conclusions —The findings of this study do not support a significant impact of abciximab on the risk of death and myocardial infa rct ion in diabetic patients undergoing percutaneous coronary interventions after pretreatment with a 600-mg loading dose of clopidogrel at least 2 hours before the procedure . The present findings suggest , however , that abciximab reduces the risk of restenosis in diabetic patients receiving coronary bare metal stents 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 
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No difference in bleeding complications was observed between IC and IV regimens .
An accumulating body of evidence suggests the superiority of IC over IV abciximab administration in STEMI patients .