Diabetes is not sufficient justification for IIb/IIIa use in percutaneous coronary intervention.
Diabetics, particularly insulin treated, have increased risk of ischemic events and bleeding with percutaneous coronary intervention (PCI). The relative risk of atherothrombotic versus bleeding events is higher in diabetics than non-diabetics. Bivalirudin with provisional IIb/IIIa therapy has less bleeding and lower one-year mortality than routine IIb/IIIa therapy in diabetics undergoing PCI. IIb/IIIa agents should be reserved for provisional and niche applications during PCI.
Heath South Cardiovascular Group, Alabaster, Alabama.|Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama.
William B
WB
Hillegass
D000925:Anticoagulants / Q000627:therapeutic use*; D000991:Antithrombins / Q000627:therapeutic use*; D003327:Coronary Disease / Q000628:therapy*; D048909:Diabetes Complications; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*
D000925:Anticoagulants; D000991:Antithrombins; D010446:Peptide Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D006493:Heparin