title: Procedural and clinical outcomes after use of the glycoprotein IIb/IIIa inhibitor abciximab for saphenous vein graft interventions.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) poses a high-risk for distal coronary thromboembolic events. Glycoprotein IIb/IIIa inhibitors are frequently used in hope of reducing the impact of this, although the safety and efficacy of these drugs to improve outcomes in this setting are understudied.
  
  
  METHODS
  Patients were included if they had prior coronary artery bypass surgery and subsequently underwent PCI of ≥1 SVG graft at a Dutch academic center between 1997 and 2008. These patients were matched 1:1 based on peri-procedural use of abciximab using a propensity-score matching algorithm based on 17 variables. Conditional logistic regression and Cox regression stratified on matched pairs were performed to evaluate the association between abciximab use and MACCE (the composite measure of mortality, myocardial infarction, stroke and repeat revascularization) at 30days and up to 1year.
  
  
  RESULTS
  The composite of 30-day MACCE occurred in 18 patients (15.3%) in the abciximab group and 16 patients (13.6%) in the propensity matched control group (OR: 1.13, 95% CI: 0.57-2.21, p=0.73). At 1-year follow-up, MACCE rates were also similar (32.5% vs. 33.9%, HR: 0.97, 95% CI: 0.59-1.59). Major bleeding (BARC types 3a-c) was higher in the abciximab group (11.9% vs. 4.2%, OR: 2.80, 95% CI: 1.01-7.77). Ischemic outcomes did not differ among patients with acute coronary syndromes.
  
  
  CONCLUSIONS
  The use of intravenous abciximab was not associated with improved clinical outcomes up to 1-year among patients undergoing SVG PCI, but was related to more bleeding.
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands; VU University Medical Center, Amsterdam, the Netherlands; Duke Clinical Research Institute, Durham, NC, USA. Electronic address: r.e.harskamp@gmail.com.
authors.forename: Ralf E
authors.initials: RE
authors.lastname: Harskamp
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Niels
authors.initials: N
authors.lastname: Hoedemaker
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: L Kristin
authors.initials: LK
authors.lastname: Newby
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Pier
authors.initials: P
authors.lastname: Woudstra
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Maik J
authors.initials: MJ
authors.lastname: Grundeken
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Beijk
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Jan G
authors.initials: JG
authors.lastname: Tijssen
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Rajendra H
authors.initials: RH
authors.lastname: Mehta
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
mesh_terms: D000077284:Abciximab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000494:pharmacology*; D003328:Coronary Thrombosis / Q000517:prevention & control*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology; D012501:Saphenous Vein / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab
keywords: Clinical outcomes; Glycoprotein IIb/IIIa inhibitor; Percutaneous coronary intervention; Saphenous vein graft