Efficacy and safety of abciximab in combination with cilostazol in patients undergoing stenting.
OBJECTIVE
To evaluate the short- and long-term efficacy and safety of abciximab and cilostazol in patients with acute MI and unstable angina undergoing intracoronary stenting.


METHODS
Acute-phase (7 and 30 days), 6-month and long-term composite outcomes involving death, myocardial infarction or urgent target vessel revascularization (TVR) together with other outcomes (composite outcomes involving death, MI and elective TVR with restenosis and stroke) were evaluated retrospectively in a total of 175 patients. Safety outcomes were assessed using data on the incidence of bleeding and thrombocytopenia at Day 7 and Day 30.


RESULTS
Of 175 patients, 83 (47.4%) patients received abciximab. At 7 and 30 days, the composite outcome for the group treated with cilostazol alone and that treated with abciximab in combination with cilostazol did not differ significantly. The composite outcomes at 6 months and 1 year were significantly lower in the abciximab plus cilostazol group (relative risk 0.35, 95% Cl 0.13 - 0.90, relative risk 0.28, 95% CI 0.10 -0.78, respectively). The incidence of major bleeding at the access-site and in the gastrointestinal tract and minor bleeding were significantly higher in the group receiving abciximab plus cilostazol group at 7 days (relative risk 3.33, 95% CI 1.66 - 6.65, relative risk 9.98, 95% CI 1.29 - 77.07, relative risk 1.96, 95% CI 1.06 - 3.62, respectively) and at 30 days (relative risk 3.33, 95% CI 1.66 - 6.65, relative risk 5.54, 95% CI 1.25 - 24.56, relative risk 1.96, 95% CI 1.06 - 3.62, respectively).


CONCLUSIONS
The combination of abciximab and cilostazol showed an improvement in major cardiac incidents at 6 months and 1 year of the treatment when compared to the group receiving cilostazol alone. However, abciximab did not improve the incidence of death but increased the risk of bleeding complications.
Hong
E H
EH
Department of Pharmacy, Sejong Hospital, Gyeonggi-do, Korea.
Kim
M Y
MY
Park
J E
JE
Lee
M H
MH
Oh
J M
JM
Shin
W G
WG
D000077284:Abciximab; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D000077407:Cilostazol; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects* / Q000627:therapeutic use*; D007723:Korea; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D015607:Stents; D013777:Tetrazoles / Q000009:adverse effects* / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000453:epidemiology; D013927:Thrombosis / Q000517:prevention & control*; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol; D000077284:Abciximab