title: Efficacy and safety of abciximab in diabetic patients who underwent percutaneous coronary intervention with thienopyridines loading: a meta-analysis.
abstract: BACKGROUND
  It has been controversial whether abciximab offered additional benefits for diabetic patients who underwent percutaneous coronary intervention (PCI) with thienopyridines loading.
  
  
  METHODS
  MEDLINE, EMBASE, the Cochrane library clinical trials registry, ISI Science Citation Index, ISI Web of Knowledge and China National Knowledge Infrastructure (CNKI) were searched, supplemented with manual-screening for relevant publications. Quantitative meta-analyses were performed to assess differences between abciximab groups and controls with respect to post-PCI risk of major cardiac events (MACEs), angiographic restenosis and bleeding complications.
  
  
  RESULTS
  9 trials were identified, involving 2,607 diabetic patients receiving PCI for coronary artery diseases. Among those patients who underwent elective PCI or primary PCI, pooling results showed that abciximab did not significantly reduce risks of MACEs (for elective-PCI patients: RR(1-month): 0.93, 95% CI: 0.60-1.44; RR(1-year): 0.95, 95% CI: 0.81-1.11; for primary-PCI patients: RR(1-month): 1.05, 95% CI: 0.70-1.57; RR(1-year): 0.98, 95% CI: 0.80-1.21), nor all-cause mortality, re-infarction and angiographic restenosis in either group. The only beneficial effect by abciximab appeared to be a decrease 1-year TLR (target lesion revascularization) risk in elective-PCI patients (RR1-year: 0.83, 95% CI: 0.70-0.99). Moreover, occurrence of minor bleeding complications increased in elective-PCI patients treated with abciximab (RR: 2.94, 95% CI: 1.68-5.13, P<0.001), whereas major bleedings rate was similar (RR: 0.83, 95% CI: 0.27-2.57).
  
  
  CONCLUSIONS
  Concomitant dosing of abciximab and thienopyridines provides no additional benefit among diabetic patients who underwent PCI; this conclusion, though, needs further confirmation in larger studies.
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Wu
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.forename: Han
authors.initials: H
authors.lastname: Wu
authors.forename: Chang
authors.initials: C
authors.lastname: Bian
authors.forename: Qian
authors.initials: Q
authors.lastname: Tang
authors.forename: Geng
authors.initials: G
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000209:etiology / Q000628:therapy; D016208:Databases, Factual; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D058924:Thienopyridines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D058924:Thienopyridines; D000077284:Abciximab