Beneficial effects of abciximab in patients with primary percutaneous intervention for acute ST segment elevation myocardial infarction in clinical practice.

OBJECTIVES: To assess the safety and effectiveness of abciximab in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) in clinical practice. METHODS: Data were analysed of 2184 consecutive patients treated with primary PCI for acute STEMI and either concomitant abciximab or no glycoprotein IIb/IIIa inhibitor (control group), who were prospectively enrolled in the Acute Coronary Syndromes (ACOS) registry between July 2000 and November 2002. RESULTS: Patients who were treated with abciximab were younger than the control group, and fewer of them had a history of stroke/transient ischaemic attack and systemic hypertension, but more of them had three-vessel coronary artery disease and cardiogenic shock. Cumulated mid-term survival for patients treated with abciximab was significantly higher than in the control group (91% v 79%, log rank p < 0.05, median observational time 375 days, range 12-34 months). The Cox proportional hazards model of mid-term mortality after admission with adjustment for baseline characteristics showed that mortality was significantly lower in the abciximab group than in the control group (hazard ratio 0.68, 95% confidence interval 0.49 to 0.95). Whereas overall there was no difference in bleeding complications, patients older than 75 years had more major bleeding events with abciximab (12.5% v 3.4%, p = 0.03). CONCLUSION: In clinical practice adjunctive treatment with abciximab in patients with primary PCI for acute STEMI was associated with a reduction in mid-term mortality. The subgroup of patients older than 75 years who were treated with abciximab had more major bleeding complications.

Tetraspanin-5 (Tm4sf9) mRNA expression parallels neuronal maturation in the cerebellum of normal and L7En-2 transgenic mice.

Tetraspanin-5 (Tspan-5) mRNA was recently shown to be strongly expressed within the central nervous system. In order to address Tspan-5 function during nervous system development, we performed a detailed expression analysis in the postnatal FVB/N mouse cerebellum using in situ hybridizations. Tspan-5 mRNA was expressed within cerebellar Purkinje cells (PCs) throughout postnatal development. The expression level, however, changed significantly with ongoing development. At the day of birth (P0), Tspan-5 mRNA was expressed at very low levels in PCs. At this time, PCs of the FVB/N strain are postmitotic and bear axons, but no dendrites. At P7, Tspan-5 mRNA expression was visible in all PCs, but was more prominent in those of the posterior lobules as compared to those of the anterior lobules. After P7, high levels of Tspan-5 mRNA were seen in all PCs, which is when PCs elaborate and maintain their typical dendritic tree. This demonstrates that the level of Tspan-5 mRNA is related to the developmental status of PCs. Consistently, expression of Tspan-5 mRNA was specifically reduced in PCs of L7En-2 animals, which display a delay in PC maturation during postnatal cerebellar development. In addition, whereas no Tspan-5 mRNA signal could be detected in the proliferating granule cell layer, low levels could be found in postmitotic, premigratory granule cells and high levels in settled and differentiated granule cells. Thus, the level of Tspan-5 mRNA expression correlates very well with the differentiation status of particular neurons. The level of Tspan-5 expression might therefore be important for distinct phases of neuronal maturation.