Abciximab offers greater benefits to insulin-dependent diabetic patients undergoing coronary stent implantation.
OBJECTIVE
Abciximab use does not exceed 25% in most of the studies on diabetic patients undergoing stent implantation. The aim of this study was to evaluate whether abciximab could be more beneficial in different subgroups such as insulin-dependent (ID) patients and whether its use could provide additional benefits to those afforded by drug-eluting stents in these patients.


METHODS
A total of 373 consecutive diabetics [223 non-insulin-dependent (NID) and 150 ID patients] who had undergone stent implantation were examined with a follow-up of 25.6+/-16.2 months. Abciximab was used in 21.7%.


RESULTS
The abciximab-treated group had a lower rate of revascularization (26.8% vs. 15.8%. P=.02). The results by subgroups were as follows: NID nonabciximab, 23.5%; NID abciximab, 19% (P=NS); ID nonabciximab, 32.7%; ID abciximab, 12.2% (P=.05). In multivariate analysis, the restenosis predictors were insulin dependency (OR, 2.7), abciximab use (OR, 0.18), stent diameter (OR, 0.18).


CONCLUSIONS
Abciximab use in diabetics with stent implantation has a favorable effect by reducing the need for new revascularization. This benefit is more evident in ID patients; the negative prognosis effect of being insulin-dependent is eliminated, and the percentage of events in this population over a long follow-up period is equal to those in NID patients.
López-Mínguez
José R
JR
Department of Cardiology, Hemodynamics and Interventionist Cardiology Section, Infanta Cristina University Hospital, Badajoz, Spain. lopez-minguez@hotmail.com
Nogales
Juan M
JM
González
Reyes
R
Palanco
Carlos
C
Doncel
Javier
J
Vaello
Alejandra
A
Giménez
Fernando
F
Morales
Angel
A
Alonso
Rafael
R
Merchán
Antonio
A
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D023903:Coronary Restenosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D002317:Cardiovascular Agents; D007140:Immunoglobulin Fab Fragments; D008670:Metals; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab