Restoration of coronary blood flow by single bolus injection of the gpiib/iiia receptor antagonist c7e3 fab in a patient with acute myocardial infarction of recent onset

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Abstract
It has been debated that primary coronary angioplasty could be more effective if immediate antithrombotic therapy would contribute to a faster recanalization of the infarct‐related artery. This is the first report of a patient who presented at the emergency department with acute anterolateral myocardial infarction, in whom a single bolus injection of c7E3 Fab (0.25 mg/kg body weight) led to complete reperfusion of the infarct‐related coronary artery during organization time for planned acute coronary angioplasty. Pain relief 15 min after initiation of therapy and ST‐segment resolution of >50%, as well as occurrence of idioventricular rhythm 30 min thereafter, were suggestive of successful recanalization before the coronary intervention was started. Diagnostic coronary angiography at 90 min revealed TIMI‐grade 3 flow in the infarctrelated coronary artery with only moderate luminal irregularities. Bolus administration of c7E3 Fab could be effective for dissolving platelet‐rich thrombi in the early stage of acute myocardial infarction (AMI) and may therefore represent a promising “bridging” therapy in patients with AMI elected for primary coronary angioplasty.

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