Abciximab offers greater benefits to insulin-dependent diabetic patients undergoing coronary stent implantation

Cardiovasc Revasc Med. 2007 Jul-Sep;8(3):175-82. doi: 10.1016/j.carrev.2007.03.005.

Abstract

Introduction and objectives: Abciximab use does not exceed 25% in most of the studies on diabetic patients undergoing stent implantation. The aim of this study was to evaluate whether abciximab could be more beneficial in different subgroups such as insulin-dependent (ID) patients and whether its use could provide additional benefits to those afforded by drug-eluting stents in these patients.

Patients and methods: A total of 373 consecutive diabetics [223 non-insulin-dependent (NID) and 150 ID patients] who had undergone stent implantation were examined with a follow-up of 25.6+/-16.2 months. Abciximab was used in 21.7%.

Results: The abciximab-treated group had a lower rate of revascularization (26.8% vs. 15.8%. P=.02). The results by subgroups were as follows: NID nonabciximab, 23.5%; NID abciximab, 19% (P=NS); ID nonabciximab, 32.7%; ID abciximab, 12.2% (P=.05). In multivariate analysis, the restenosis predictors were insulin dependency (OR, 2.7), abciximab use (OR, 0.18), stent diameter (OR, 0.18).

Conclusions: Abciximab use in diabetics with stent implantation has a favorable effect by reducing the need for new revascularization. This benefit is more evident in ID patients; the negative prognosis effect of being insulin-dependent is eliminated, and the percentage of events in this population over a long follow-up period is equal to those in NID patients.

MeSH terms

  • Abciximab
  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation
  • Antibodies, Monoclonal / therapeutic use*
  • Cardiovascular Agents / administration & dosage
  • Coronary Restenosis / etiology
  • Coronary Restenosis / mortality
  • Coronary Restenosis / prevention & control*
  • Coronary Stenosis / complications
  • Coronary Stenosis / drug therapy
  • Coronary Stenosis / mortality
  • Coronary Stenosis / therapy*
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / mortality
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / mortality
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use*
  • Kaplan-Meier Estimate
  • Male
  • Metals
  • Middle Aged
  • Odds Ratio
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Prosthesis Design
  • Risk Assessment
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Cardiovascular Agents
  • Immunoglobulin Fab Fragments
  • Metals
  • Platelet Aggregation Inhibitors
  • Abciximab