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

ABSTRACT

Background

It has been controversial whether abciximab offered additional benefits for
diabetic patients who underwent percutaneous coronary intervention (PCI)
with thienopyridines loading.


Methods

MEDLINE, 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.


Results

9 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).


Conclusions

Concomitant 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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Publisher: Public Library of Science

Date Published: 3-June-2011

Author(s): Wu Y., Shi Y., Wu H., Bian C., Tang Q., Xu G., Yang J.

Link: https://doi.org/10.1371/journal.pone.0020759

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