To the Editor: We would like to raise 2 issues
in response to the article reporting results of the Beyond 12 hours Reperfusion
AlternatiVe Evaluation (BRAVE-2) trial by Dr Schömig and colleagues.1 First, the use of abciximab before PCI in patients
with acute MI within 12 hours of symptom onset has been shown to reduce the
30-day incidence of death and MI, and this benefit is independent of the type
of device used during the procedure.2 Given
this, abciximab alone could have accounted for the reduction in infarct size
found in these patients rather than combined effect of abciximab and primary
PCI. In addition, the absence of benefit for the secondary clinical end points
suggests that an effect modification may have occurred between the 2 modes
of therapy among the patients in the intensive treatment group.
Mechanical Reperfusion More Than 12 Hours After Acute Myocardial Infarction. JAMA. 2005;294(16):2030–2032. doi:10.1001/jama.294.16.2031-a
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