title: Impact of abciximab in diabetic patients with acute coronary syndrome who undergo percutaneous coronary intervention: results from a high-volume, single-center registry.
abstract: BACKGROUND
  The prevalence of diabetes mellitus (DM) and ischemic heart disease is increasing. Moreover, patients with DM experiencing an acute coronary syndrome (ACS) have an increased risk of adverse outcomes after revascularization compared to non-diabetics. Data have suggested that the glycoprotein IIb/IIIa inhibitor abciximab might be more efficient in diabetics than in those without DM.
  
  
  RESULTS
  We evaluated the effect of abciximab in patients with DM and ACS from our percutaneous coronary intervention (PCI) registry. Among 5,003 patients with ACS who underwent PCI, 629 had DM. Patients were followed for up to 3 years with regard to mortality, myocardial infarction (MI) and target vessel revascularization (TVR). Despite a more severe risk profile, adjusted analyses revealed a marked reduction in TVR (hazard ratio [HR], 0.30; confidence interval [CI], 0.14-0.63; p = 0.002), mortality (HR, 0.53; CI, 0.28-0.97; p = 0.04) and the combined endpoint, also including MI (HR, 0.53; CI, 0.35-0.79; p = 0.002) in the DM patients who received abciximab compared to those who did not, resulting in a risk of reaching the endpoints at levels similar to the risk in patients without DM. The reduction in MI was not significant.
  
  
  CONCLUSIONS
  Our findings suggest that abciximab administered to ACS patients with DM during PCI reduces mortality and the need for TVR to rates similar to those seen in patients without DM and far below the risk in DM patients who do not receive abciximab.
authors.affiliation: Department of Cardiology P, Gentofte University Hospital, Niels Andersens Vej 65, DK-2900, Hellerup, Denmark. allive01@geh.regionh.dk
authors.forename: Allan Z
authors.initials: AZ
authors.lastname: Iversen
authors.forename: Sune H
authors.initials: SH
authors.lastname: Pedersen
authors.forename: Christian
authors.initials: C
authors.lastname: Joens
authors.forename: Rasmus
authors.initials: R
authors.lastname: Mogelvang
authors.forename: Soren
authors.initials: S
authors.lastname: Galatius
authors.forename: Anders
authors.initials: A
authors.lastname: Galloe
authors.forename: Ulrik
authors.initials: U
authors.lastname: Abildgaard
authors.forename: Peter R
authors.initials: PR
authors.lastname: Hansen
authors.forename: Jan K
authors.initials: JK
authors.lastname: Madsen
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
mesh_terms: D000077284:Abciximab; D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D000787:Angina Pectoris / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000503:physiopathology; D003718:Denmark / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000517:prevention & control; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D016016:Proportional Hazards Models; D012042:Registries; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077284:Abciximab