Korean J Intern Med.  2003 Sep;18(3):129-137.

Long-Term Clinical Benefits of a Platelet Glycoprotein IIb/IIIa Receptor Blocker, Abciximab (ReoPro (R) ), in High-Risk Diabetic Patients undergoing Percutaneous Coronary Intervention

• Sim DS
• Jeong MH
• Kim W
• Rhew JY
• Yum JH
• Kim JH
• Cho JG
• Ahn YK
• Park JC
• Ahn BH
• Kim SH
• Kang JC

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 (R) ) 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 (R) 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 I, 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 (R) used in high-risk PCI in diabetics was effective in terms of early clinical outcomes, but its long-term clinical benefits were not proven.

Keyword

Platelets; Diabetes; Myocardial infarction; Catheter-based coronary interventions

MeSH Terms

*Angioplasty, Transluminal, Percutaneous Coronary
Antibodies, Monoclonal/*therapeutic use
Comparative Study
Coronary Angiography
Coronary Stenosis/*therapy
Diabetes Mellitus/*complications/drug therapy/radiography
Female
Human
Immunoglobulins, Fab/*therapeutic use
Male
Middle Aged
Platelet Aggregation Inhibitors/*therapeutic use
Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
Risk Factors
Safety
Stents
Treatment Outcome