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

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.

Long-term clinical benefit of a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab; ReoPro(R)) in diabetic patients undergoing high-risk percutaneous coronary intervention / 대한내과학회지

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