Comparison of one-year outcomes following coronary artery stenting in diabetic versus nondiabetic patients (from the enhanced suppression of the platelet IIb/IIIa receptor with integrilin therapy [ESPRIT] trial)

Marino Labinaz, Mina Madan, J. Conor O'Shea, Rakhi Kilaru, Wai Chin, Karen Pieper, Darren K McGuire, Jorge F. Saucedo, J. David Talley, Henry Lui, Michael M. Kitt, Robert M. Califf, James E. Tcheng

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Abstract

For patients undergoing nonurgent coronary stent implantation, blockade of the glycoprotein IIb/IIIa receptor with eptifibatide reduces the incidence of ischemic complications. We evaluated the interaction of eptifibatide with diabetes in patients who underwent this procedure by analyzing the 1-year outcomes of those enrolled in the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial (466 diabetic and 1,595 nondiabetic patients). At 1 year, the composite end point of death, myocardial infarction (MI), or target vessel revascuarlization (TVR) was higher in diabetic patients (24.5% vs 18.4%; p = 0.008). At 1 year, eptifibatide had a similar effect on the composite end point of death, MI, or TVR in diabetic (hazards ratio [HR] 0.71, 95% confidence interval [CI] 0.49 to 1.04) and nondiabetic patients (HR 0.80, 95% CI 0.63 to 0.99). A similar treatment effect was also seen on death or MI in both groups. The 1-year mortality rate for diabetic patients assigned to placebo was 3.5% versus 1.3% for patients receiving eptifibatide (HR 0.37, 95% CI 0.10 to 1.41); the latter rate was similar to the mortality rate of 1.4% for nondiabetic patients in the eptifibatide group. However, eptifibatide did not have a significant effect on TVR in diabetic patients (HR 0.90, 95% CI 0.57 to 1.41). Our data suggest that treatment with eptifibatide is associated with a similar relative reduction in adverse ischemic complications in diabetic and nondiabetic patients undergoing coronary stent implantation. There is no evidence of a statistical interaction in the treatment effect of eptifibatide between patients with and without diabetes.

Original languageEnglish (US)
Pages (from-to)585-590
Number of pages6
JournalAmerican Journal of Cardiology
Volume90
Issue number6
DOIs
StatePublished - Sep 15 2002

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Coronary Vessels
Blood Platelets
Therapeutics
Confidence Intervals
Myocardial Infarction
Stents
eptifibatide
Platelet Glycoprotein GPIIb-IIIa Complex
Mortality
Diabetes Complications
Placebos
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of one-year outcomes following coronary artery stenting in diabetic versus nondiabetic patients (from the enhanced suppression of the platelet IIb/IIIa receptor with integrilin therapy [ESPRIT] trial). / Labinaz, Marino; Madan, Mina; O'Shea, J. Conor; Kilaru, Rakhi; Chin, Wai; Pieper, Karen; McGuire, Darren K; Saucedo, Jorge F.; Talley, J. David; Lui, Henry; Kitt, Michael M.; Califf, Robert M.; Tcheng, James E.

In: American Journal of Cardiology, Vol. 90, No. 6, 15.09.2002, p. 585-590.

Research output: Contribution to journalArticle

Labinaz, Marino ; Madan, Mina ; O'Shea, J. Conor ; Kilaru, Rakhi ; Chin, Wai ; Pieper, Karen ; McGuire, Darren K ; Saucedo, Jorge F. ; Talley, J. David ; Lui, Henry ; Kitt, Michael M. ; Califf, Robert M. ; Tcheng, James E. / Comparison of one-year outcomes following coronary artery stenting in diabetic versus nondiabetic patients (from the enhanced suppression of the platelet IIb/IIIa receptor with integrilin therapy [ESPRIT] trial). In: American Journal of Cardiology. 2002 ; Vol. 90, No. 6. pp. 585-590.
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abstract = "For patients undergoing nonurgent coronary stent implantation, blockade of the glycoprotein IIb/IIIa receptor with eptifibatide reduces the incidence of ischemic complications. We evaluated the interaction of eptifibatide with diabetes in patients who underwent this procedure by analyzing the 1-year outcomes of those enrolled in the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial (466 diabetic and 1,595 nondiabetic patients). At 1 year, the composite end point of death, myocardial infarction (MI), or target vessel revascuarlization (TVR) was higher in diabetic patients (24.5{\%} vs 18.4{\%}; p = 0.008). At 1 year, eptifibatide had a similar effect on the composite end point of death, MI, or TVR in diabetic (hazards ratio [HR] 0.71, 95{\%} confidence interval [CI] 0.49 to 1.04) and nondiabetic patients (HR 0.80, 95{\%} CI 0.63 to 0.99). A similar treatment effect was also seen on death or MI in both groups. The 1-year mortality rate for diabetic patients assigned to placebo was 3.5{\%} versus 1.3{\%} for patients receiving eptifibatide (HR 0.37, 95{\%} CI 0.10 to 1.41); the latter rate was similar to the mortality rate of 1.4{\%} for nondiabetic patients in the eptifibatide group. However, eptifibatide did not have a significant effect on TVR in diabetic patients (HR 0.90, 95{\%} CI 0.57 to 1.41). Our data suggest that treatment with eptifibatide is associated with a similar relative reduction in adverse ischemic complications in diabetic and nondiabetic patients undergoing coronary stent implantation. There is no evidence of a statistical interaction in the treatment effect of eptifibatide between patients with and without diabetes.",
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AU - Labinaz, Marino

AU - Madan, Mina

AU - O'Shea, J. Conor

AU - Kilaru, Rakhi

AU - Chin, Wai

AU - Pieper, Karen

AU - McGuire, Darren K

AU - Saucedo, Jorge F.

AU - Talley, J. David

AU - Lui, Henry

AU - Kitt, Michael M.

AU - Califf, Robert M.

AU - Tcheng, James E.

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