Effectiveness of a pilot intervention to reduce abciximab-related bleeding in patients with acute coronary syndromes

Int J Clin Pharm. 2014 Aug;36(4):821-6. doi: 10.1007/s11096-014-9972-3. Epub 2014 Jun 20.

Abstract

Background and objective: Reducing bleeding events is a priority in patients diagnosed with acute coronary syndromes (ACS). The effectiveness of optimization measures for reducing abciximab-related bleeding was evaluated through the implementation of a pilot program developed by the Pharmacy and the Cardiology Departments at a tertiary-care hospital.

Main outcome measure: Percentage of bleeding events.

Results: Intervention was effective in reducing the incidence of the three factors associated with an increased risk of bleeding between the pre-intervention phase (n = 86) and the post-intervention phase (n = 73): unknown body weight (24.4 vs. 1.4 %, p = 0.0001), overdosing (31.4 vs. 0 %, p < 0.0001) and combination with bivalirudin (12.8 vs. 1.4 %, p = 0.016). Bleeding events associated with these factors were numerically reduced in all three cases but these differences were not statistically significant between both periods.

Conclusion: The implementation of a multidisciplinary prevention program can reduce situations associated with an increased risk of bleeding in patients treated with abciximab. Larger scale trials are needed to confirm whether such programs can also reduce the incidence of bleeding at a statistically significant level.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abciximab
  • Acute Coronary Syndrome / drug therapy*
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antithrombins / adverse effects
  • Antithrombins / therapeutic use
  • Body Weight
  • Cohort Studies
  • Drug Dosage Calculations
  • Drug Therapy, Combination / adverse effects
  • Female
  • Hemorrhage / chemically induced
  • Hemorrhage / epidemiology
  • Hemorrhage / prevention & control*
  • Hirudins / adverse effects
  • Humans
  • Immunoglobulin Fab Fragments / administration & dosage
  • Immunoglobulin Fab Fragments / adverse effects*
  • Immunoglobulin Fab Fragments / therapeutic use
  • Incidence
  • Male
  • Middle Aged
  • Peptide Fragments / adverse effects
  • Peptide Fragments / therapeutic use
  • Pharmacy Service, Hospital*
  • Pilot Projects
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Tertiary Care Centers
  • Workforce

Substances

  • Antibodies, Monoclonal
  • Antithrombins
  • Hirudins
  • Immunoglobulin Fab Fragments
  • Peptide Fragments
  • Platelet Aggregation Inhibitors
  • Recombinant Proteins
  • bivalirudin
  • Abciximab