OBJECTIVES: To study the glycoprotein IIb/IIIa inhibitors abciximab (AB) in the actual use (uncontrolled) setting. METHODS: The study evaluated 291 patients who did (n=145) or did not (n=146) receive AB as adjunct treatment for PTCA at 8 US academic centers. Based on product labeling, all patients were eligible to receive AB. Data came from hospital records and six month follow up interviews. RESULTS: Most patients (87%) were treated by physicians who chose AB in some but not others. Previous MI (by history or as PTCA indication) and urgent admission status were more common (p<0.05) in the AB group, while angina unresponsive to medical therapy (ANGU) and restenosis as indications for the PTCA were more common (p<0.05) in the non-AB group. Bleeding and other complications were comparable between the two groups. Six-month data were: AB (n=145), No AB (n=146) and P-Value where Deaths were 6, 2, NS; Non-Fatal MI were 12, 12, NS; Revascularization were 25, 23, NS; and Other Cardiac Hospitalization were 17, 29, 0.057, respectively. ANGU (OR, 2.26, p=0.02) and AB and stents (OR, 0.61,p=0.04) affected other cardiac hospitalizations (e.g., CHF, arrhythmia). The combination of AB and stents seemed to provide the best results for preventing other cardiac hospitalizations. CONCLUSION: Within labeled indications, physicians seemed to select AB use based on certain patient characteristics. The number of patients requiring subsequent cardiac-related hospitalizations after six months tended to be less in the abciximab-treated patients providing economic offsets. Further studies are warranted to validate these observations and the implications for health care reimbursement and practice guidelines.