Seven RCTs were included in the review (3,311 participants). Five RCTs were reported to be open-label. One RCT was double-blind.
There was no significant difference in all-cause mortality between intracoronary abciximab administration and intravenous abciximab administration (seven RCTs).
Compared with intravenous abciximab administration, intracoronary abciximab administration was associated with a significant reduction in the rate of recurrent myocardial infarction (OR 0.61, 95% CI 0.40 to 0.92; five RCTs). No significant differences were found between the two groups in terms of the rates of target vessel revascularization and major bleeding complications.
Significant heterogeneity was found for the outcomes of all-cause mortality (Ι²=83.1%) and recurrent myocardial infarction (Ι²=69.9%). Sensitivity analyses that excluded the AIDA STEMI trial showed that intracoronary abciximab administration was associated with a significant reduction in all-cause mortality compared with intravenous abciximab administration. There was no evidence of publication bias.