title: Safety and efficacy of abciximab in older adults undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  As a result of increased cost and bleeding concerns, older patients receive abciximab during percutaneous coronary intervention (PCI) less often than younger patients.
  
  
  OBJECTIVE
  The aim of this was to evaluate the safety and efficacy of abciximab in older adults undergoing PCI.
  
  
  METHODS
  Retrospective, observational single centre cohort study.
  
  
  METHODS
  The British Cardiovascular Intervention Society (BCIS) database was used to establish the impact of abciximab in people with advanced age (≥ 75 years) on in-hospital bleeding and ischaemic events and all-cause mortality in 5727 consecutive patients undergoing PCI between January 2008 and June 2014.
  
  
  RESULTS
  Older patients represented 23% of the study population (n = 1298). Abciximab was used in 198 (15%) older patients and 970 (22%) younger patients (p < 0.001). Unadjusted bleeding and mortality rates were 1.2% and 5.6%, respectively, vs. 0.4% and 1.7% in younger patients (p = 0.001 and p < 0.001 respectively). On multivariate analysis older subjects were at higher risk of bleeding [odds ratio (OR) 2.76, 95% confidence interval (CI) 1.26-6.04, p = 0.011] and had higher in-hospital mortality (OR 2.36, 95% CI 1.48-3.74, p < 0.001). The use of abciximab in older patients was not significantly associated with excess bleeding (adjusted OR 1.86, 95% CI 0.58-5.93, p = 0.3), ischaemic outcomes (adjusted OR, 95% CI, p = 0.12) or in-hospital mortality (adjusted OR, 95% CI, p = 0.11). Older patients having primary PCI had higher risk of bleeding irrespective of abciximab use (adjusted p = 0.042).
  
  
  CONCLUSIONS
  Abciximab may not be associated with excess bleeding complications in older patients compared with younger individuals and may be safe to use in older people if indicated.
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Brown
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.|Cardiology Department, Sandwell and West Birmingham Hospitals NHS Trust (City Hospital, Birmingham and Sandwell Hospital, West Bromwich), UK.
authors.forename: E
authors.initials: E
authors.lastname: Shantsila
authors.affiliation: Cardiology Department, Sandwell and West Birmingham Hospitals NHS Trust (City Hospital, Birmingham and Sandwell Hospital, West Bromwich), UK.
authors.forename: C
authors.initials: C
authors.lastname: Varma
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.|Cardiology Department, Sandwell and West Birmingham Hospitals NHS Trust (City Hospital, Birmingham and Sandwell Hospital, West Bromwich), UK.
authors.forename: G Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000077284:Abciximab; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D007511:Ischemia / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab