Abciximab reduces mortality in diabetics following percutaneous coronary intervention

Deepak L. Bhatt, Steven P. Marso, A. Michael Lincoff, Katherine E. Wolski, Stephen G. Ellis, Eric J. Topol

Research output: Contribution to journalArticle

306 Citations (Scopus)

Abstract

OBJECTIVES. We sought to determine whether abciximab therapy at the time of percutaneous coronary intervention (PCI) would favorably affect one-year mortality in patients with diabetes. BACKGROUND. Diabetics are known to have increased late mortality following PCI. METHODS. Data from three placebo-controlled trials of PCI, EPIC, EPILOG, and EPISTENT, were pooled. The one-year mortality rate for patients with a clinical diagnosis of diabetes mellitus was compared with the rate for nondiabetic patients treated with either abciximab or placebo. RESULTS. In the 1,462 diabetic patients, abciximab decreased the mortality from 4.5% to 2.5%, p = 0.031, and in the 5,072 nondiabetic patients, from 2.6% to 1.9%, p = 0.099. In patients with the clinical syndrome of insulin resistance- defined as diabetes, hypertension, and obesity-mortality was reduced by abciximab treatment from 5.1% to 2.3%, p = 0.044. The beneficial reduction in mortality with abciximab use in diabetics classified as insulin-requiring was from 8.1% to 4.2%, p = 0.073. Mortality in diabetics who underwent multivessel intervention was reduced from 7.7% to 0.9% with use of abciximab, p = 0.018. In a Cox proportional hazards survival model, the risk ratio for mortality with abciximab use compared with placebo was 0.642 (95% confidence interval 0.458- 0.900, p = 0.010). CONCLUSIONS. Abciximab decreases the mortality of diabetic patients to the level of placebo-treated nondiabetic patients. This beneficial effect is noteworthy in those diabetic who are also hypertensive and obese and in diabetics undergoing multivessel intervention. Besides its potential role in reducing repeat intervention for stented diabetic patients, abciximab therapy should be stongly considered in diabetic patients undergoing PCI to improve their survival. (C) 2000 by the American College of Cardiology.

Original languageEnglish (US)
Pages (from-to)922-928
Number of pages7
JournalJournal of the American College of Cardiology
Volume35
Issue number4
DOIs
StatePublished - Mar 15 2000

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Percutaneous Coronary Intervention
Mortality
Placebos
abciximab
Survival
Proportional Hazards Models
Insulin Resistance
Diabetes Mellitus
Therapeutics
Obesity
Odds Ratio
Confidence Intervals
Insulin
Hypertension

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Abciximab reduces mortality in diabetics following percutaneous coronary intervention. / Bhatt, Deepak L.; Marso, Steven P.; Lincoff, A. Michael; Wolski, Katherine E.; Ellis, Stephen G.; Topol, Eric J.

In: Journal of the American College of Cardiology, Vol. 35, No. 4, 15.03.2000, p. 922-928.

Research output: Contribution to journalArticle

Bhatt, Deepak L. ; Marso, Steven P. ; Lincoff, A. Michael ; Wolski, Katherine E. ; Ellis, Stephen G. ; Topol, Eric J. / Abciximab reduces mortality in diabetics following percutaneous coronary intervention. In: Journal of the American College of Cardiology. 2000 ; Vol. 35, No. 4. pp. 922-928.
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abstract = "OBJECTIVES. We sought to determine whether abciximab therapy at the time of percutaneous coronary intervention (PCI) would favorably affect one-year mortality in patients with diabetes. BACKGROUND. Diabetics are known to have increased late mortality following PCI. METHODS. Data from three placebo-controlled trials of PCI, EPIC, EPILOG, and EPISTENT, were pooled. The one-year mortality rate for patients with a clinical diagnosis of diabetes mellitus was compared with the rate for nondiabetic patients treated with either abciximab or placebo. RESULTS. In the 1,462 diabetic patients, abciximab decreased the mortality from 4.5{\%} to 2.5{\%}, p = 0.031, and in the 5,072 nondiabetic patients, from 2.6{\%} to 1.9{\%}, p = 0.099. In patients with the clinical syndrome of insulin resistance- defined as diabetes, hypertension, and obesity-mortality was reduced by abciximab treatment from 5.1{\%} to 2.3{\%}, p = 0.044. The beneficial reduction in mortality with abciximab use in diabetics classified as insulin-requiring was from 8.1{\%} to 4.2{\%}, p = 0.073. Mortality in diabetics who underwent multivessel intervention was reduced from 7.7{\%} to 0.9{\%} with use of abciximab, p = 0.018. In a Cox proportional hazards survival model, the risk ratio for mortality with abciximab use compared with placebo was 0.642 (95{\%} confidence interval 0.458- 0.900, p = 0.010). CONCLUSIONS. Abciximab decreases the mortality of diabetic patients to the level of placebo-treated nondiabetic patients. This beneficial effect is noteworthy in those diabetic who are also hypertensive and obese and in diabetics undergoing multivessel intervention. Besides its potential role in reducing repeat intervention for stented diabetic patients, abciximab therapy should be stongly considered in diabetic patients undergoing PCI to improve their survival. (C) 2000 by the American College of Cardiology.",
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AU - Bhatt, Deepak L.

AU - Marso, Steven P.

AU - Lincoff, A. Michael

AU - Wolski, Katherine E.

AU - Ellis, Stephen G.

AU - Topol, Eric J.

PY - 2000/3/15

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N2 - OBJECTIVES. We sought to determine whether abciximab therapy at the time of percutaneous coronary intervention (PCI) would favorably affect one-year mortality in patients with diabetes. BACKGROUND. Diabetics are known to have increased late mortality following PCI. METHODS. Data from three placebo-controlled trials of PCI, EPIC, EPILOG, and EPISTENT, were pooled. The one-year mortality rate for patients with a clinical diagnosis of diabetes mellitus was compared with the rate for nondiabetic patients treated with either abciximab or placebo. RESULTS. In the 1,462 diabetic patients, abciximab decreased the mortality from 4.5% to 2.5%, p = 0.031, and in the 5,072 nondiabetic patients, from 2.6% to 1.9%, p = 0.099. In patients with the clinical syndrome of insulin resistance- defined as diabetes, hypertension, and obesity-mortality was reduced by abciximab treatment from 5.1% to 2.3%, p = 0.044. The beneficial reduction in mortality with abciximab use in diabetics classified as insulin-requiring was from 8.1% to 4.2%, p = 0.073. Mortality in diabetics who underwent multivessel intervention was reduced from 7.7% to 0.9% with use of abciximab, p = 0.018. In a Cox proportional hazards survival model, the risk ratio for mortality with abciximab use compared with placebo was 0.642 (95% confidence interval 0.458- 0.900, p = 0.010). CONCLUSIONS. Abciximab decreases the mortality of diabetic patients to the level of placebo-treated nondiabetic patients. This beneficial effect is noteworthy in those diabetic who are also hypertensive and obese and in diabetics undergoing multivessel intervention. Besides its potential role in reducing repeat intervention for stented diabetic patients, abciximab therapy should be stongly considered in diabetic patients undergoing PCI to improve their survival. (C) 2000 by the American College of Cardiology.

AB - OBJECTIVES. We sought to determine whether abciximab therapy at the time of percutaneous coronary intervention (PCI) would favorably affect one-year mortality in patients with diabetes. BACKGROUND. Diabetics are known to have increased late mortality following PCI. METHODS. Data from three placebo-controlled trials of PCI, EPIC, EPILOG, and EPISTENT, were pooled. The one-year mortality rate for patients with a clinical diagnosis of diabetes mellitus was compared with the rate for nondiabetic patients treated with either abciximab or placebo. RESULTS. In the 1,462 diabetic patients, abciximab decreased the mortality from 4.5% to 2.5%, p = 0.031, and in the 5,072 nondiabetic patients, from 2.6% to 1.9%, p = 0.099. In patients with the clinical syndrome of insulin resistance- defined as diabetes, hypertension, and obesity-mortality was reduced by abciximab treatment from 5.1% to 2.3%, p = 0.044. The beneficial reduction in mortality with abciximab use in diabetics classified as insulin-requiring was from 8.1% to 4.2%, p = 0.073. Mortality in diabetics who underwent multivessel intervention was reduced from 7.7% to 0.9% with use of abciximab, p = 0.018. In a Cox proportional hazards survival model, the risk ratio for mortality with abciximab use compared with placebo was 0.642 (95% confidence interval 0.458- 0.900, p = 0.010). CONCLUSIONS. Abciximab decreases the mortality of diabetic patients to the level of placebo-treated nondiabetic patients. This beneficial effect is noteworthy in those diabetic who are also hypertensive and obese and in diabetics undergoing multivessel intervention. Besides its potential role in reducing repeat intervention for stented diabetic patients, abciximab therapy should be stongly considered in diabetic patients undergoing PCI to improve their survival. (C) 2000 by the American College of Cardiology.

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