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

• Published in: Cardiovascular revascularization medicine 2007-07, Vol.8 (3), p.175-182
• Main Authors: López-Mínguez, José R, Nogales, Juan M, González, Reyes, Palanco, Carlos, Doncel, Javier, Vaello, Alejandra, Giménez, Fernando, Morales, Angel, Alonso, Rafael, Merchán, Antonio
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Antibodies, Monoclonal - therapeutic use; Cardiovascular; 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; 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; Platelet Aggregation Inhibitors - therapeutic use; Prosthesis Design; Risk Assessment; Risk Factors; Stent; Stents; Time Factors; Treatment Outcome
• ISSN: 1553-8389; 1878-0938
• 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.