Literature DB >> 14619381

Long-term clinical benefits of a platelet glycoprotein IIb/IIIa receptor blocker, abciximab (ReoPro), in high-risk diabetic patients undergoing percutaneous coronary intervention.

Doo Sun Sim1, Myung Ho Jeong, Weon Kim, Jay Young Rhew, Ju Hyup Yum, Ju Han Kim, Jeong Gwan Cho, Young Keun Ahn, Jong Chun Park, Byoung Hee Ahn, Sang Hyung Kim, Jung Chaee Kang.   

Abstract

BACKGROUND: High-risk percutaneous coronary interventions (PCIs) are associated with a high complication rate, a low procedural success rate and a high restenosis rate, especially in diabetics. We sought to determine whether abciximab (ReoPro) therapy affects long-term clinical outcomes of Korean patients with diabetes undergoing high-risk PCI.
METHODS: One hundred and nineteen patients with 152 lesion sites were administered ReoPro among 2,231 patients who underwent PCI at Chonnam National University Hospital from March 1999 to Feb 2001. These 119 patients were divided into two groups, 30 were allocated to a diabetic group (Group 1, 57.7 +/- 8.2 years, 22 male), and 89 to a non-diabetic group (Group II, 59.6 +/- 10.8 years, 68 male). Early and long-term clinical outcomes after PCI were analyzed.
RESULTS: In terms of clinical diagnosis, the number of acute myocardial infarctions in Group I was 25 (83.3%) and 76 in Group II (85.4%). As for risk factors, target artery lesions, and ACC/AHA types, no differences were found between the two groups. The number of patients with total occlusion was 21 (55.3%) and 62 (53.9%), and the number with a thrombus-containing lesion was 28 (93.3%) and 88 (98.9%) in Groups I and II, respectively. The procedure was successful in 27 (90.0%) in Group I, and in 80 (89.9%) in Group II, and no differences were evident between the two groups in terms of bleeding complications. No major adverse cardiac events (MACE), including myocardial infarction, repeat revascularization or cardiac death, were observed in Group I, but 8 cases of MACE occurred in Group II during hospitalization. Clinical follow-up was performed in 116 patients (97.5%) over 18.5 +/- 6.7 (5-28) months. The number of overall MACEs was 10 (3.3%) in Group I and 14 (15.7%) in Group II (p = 0.038).
CONCLUSION: ReoPro used in high-risk PCI in diabetics was effective in terms of early clinical outcomes, but its long-term clinical benefits were not proven.

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Year:  2003        PMID: 14619381      PMCID: PMC4531627          DOI: 10.3904/kjim.2003.18.3.129

Source DB:  PubMed          Journal:  Korean J Intern Med        ISSN: 1226-3303            Impact factor:   2.884


  39 in total

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6.  Diabetes, fibrinogen, and risk of cardiovascular disease: the Framingham experience.

Authors:  W B Kannel; R B D'Agostino; P W Wilson; A J Belanger; D R Gagnon
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7.  Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance.

Authors:  H O Steinberg; H Chaker; R Leaming; A Johnson; G Brechtel; A D Baron
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8.  Predicting the risk of abrupt vessel closure after angioplasty in an individual patient.

Authors:  A N Tenaglia; D F Fortin; R M Califf; D J Frid; C L Nelson; L Gardner; M Miller; F I Navetta; J E Smith; J E Tcheng
Journal:  J Am Coll Cardiol       Date:  1994-10       Impact factor: 24.094

9.  Randomised placebo-controlled and balloon-angioplasty-controlled trial to assess safety of coronary stenting with use of platelet glycoprotein-IIb/IIIa blockade.

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10.  Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction.

Authors:  S M Haffner; S Lehto; T Rönnemaa; K Pyörälä; M Laakso
Journal:  N Engl J Med       Date:  1998-07-23       Impact factor: 91.245

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