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

López-Mínguez, José Ramón; Nogales, Juan; González, Ricardo; Palanco, C.; Doncel, J.; Vaello, Alejandra; Giménez, Fernando; Morales, A; Alonso, Rafael; Merchán, Antonio Guerra

doi:10.1016/j.carrev.2007.03.005

Cited by 6 publications

(1 citation statement)

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“…Thienopyridine inhibits ADP-induced platelet aggregation and signaling pathways within the platelet, which is different from the anti-platelet mechanism elicited by GPIIb/IIIa inhibitors such as abciximab [12], [26], [27], [28], suggesting a possibility for combination therapy, especially among the high-risk patients who need stent implantation. Such combination a regimen was also conditionally recommended in newly published guidelines [29], [30], [31], [32], [33]. Some other investigators, however, have found evidence to support the opposite view [34], [35], [36].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Abciximab in Diabetic Patients Who Underwent Percutaneous Coronary Intervention with Thienopyridines Loading: A Meta-Analysis

Shi

et al. 2011

PLoS ONE

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BackgroundIt has been controversial whether abciximab offered additional benefits for diabetic patients who underwent percutaneous coronary intervention (PCI) with thienopyridines loading.MethodsMEDLINE, EMBASE, the Cochrane library clinical trials registry, ISI Science Citation Index, ISI Web of Knowledge and China National Knowledge Infrastructure (CNKI) were searched, supplemented with manual-screening for relevant publications. Quantitative meta-analyses were performed to assess differences between abciximab groups and controls with respect to post-PCI risk of major cardiac events (MACEs), angiographic restenosis and bleeding complications.Results9 trials were identified, involving 2,607 diabetic patients receiving PCI for coronary artery diseases. Among those patients who underwent elective PCI or primary PCI, pooling results showed that abciximab did not significantly reduce risks of MACEs (for elective-PCI patients: RR1-month: 0.93, 95% CI: 0.60–1.44; RR1-year: 0.95, 95% CI: 0.81–1.11; for primary-PCI patients: RR1-month: 1.05, 95% CI: 0.70–1.57; RR1-year: 0.98, 95% CI: 0.80–1.21), nor all-cause mortality, re-infarction and angiographic restenosis in either group. The only beneficial effect by abciximab appeared to be a decrease 1-year TLR (target lesion revascularization) risk in elective-PCI patients (RR1-year: 0.83, 95% CI: 0.70–0.99). Moreover, occurrence of minor bleeding complications increased in elective-PCI patients treated with abciximab (RR: 2.94, 95% CI: 1.68–5.13, P<0.001), whereas major bleedings rate was similar (RR: 0.83, 95% CI: 0.27–2.57).ConclusionsConcomitant dosing of abciximab and thienopyridines provides no additional benefit among diabetic patients who underwent PCI; this conclusion, though, needs further confirmation in larger studies.

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