Chest
Clinical InvestigationsCardiologyAlveolar Hemorrhage as a Complication of Treatment With Abciximab
Section snippets
Materials and Methods
The records of the cardiac catheterization laboratory at Mayo Clinic, Rochester were searched electronically to identify all patients who received abciximab during the study period. We identified 2,553 such patients whose records were then further examined for a diagnosis of either alveolar hemorrhage or occurrence of hemoptysis, and by cross-checking these with records of bronchoscopic procedures during this period. This was supplemented by an informal survey of staff and Fellows in the
Results
Seven patients (six men; mean age, 75 years; range, 67 to 83 years) of the 2,553 patients (0.27%) who received abciximab were identified with proven or highly probable alveolar hemorrhage. Table 1summarizes their demographic and clinical data. No episodes of pulmonary hemorrhage were identified in the 5,412 patients who had not received abciximab, a clinically and statistically significant difference (χ2, 11.89; Fisher's Exact Test, p = 0.0003).
The use of abciximab occurred in the setting of
Discussion
The use of abciximab during and after coronary angioplasty and elective stent placement has been associated with significantly improved patient outcomes, particularly a reduction in periprocedural myocardial infarction and less need for urgent reintervention. The most significant and frequent complication has been bleeding, most frequently at the vascular access site, but also from the GI tract and only rarely intracranially.2,5 The frequency and severity of these bleeding complications appear
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