Korean J Med.  2002 Feb;62(2):171-181.

Long-term clinical benefit of a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab; ReoPro(R)) in diabetic patients undergoing high-risk percutaneous coronary intervention

• Sim DS
• Jeong MH
• Kim W
• Rhew JY
• Yum JH
• Kim JH
• Cho JG
• Ahn YK
• Park JC
• Ahn BH
• Kim SH
• Kang JC

Abstract

BACKGROUND
High-risk percutaneous coronary interventions (PCI) are associated with high complication rate, low procedural success rate and high restenosis rate, especially in diabetics. We sought to observe whether diabetes affects long-term clinical outcomes after Abciximab (ReoPro(R)) therapy in Korean patients undergoing high-risk PCI.
METHODS
One hundred nineteen patients with 152 lesion sites were administered ReoPro(R) out of 2,231 patients who underwent PCI at Chonnam National University Hospital from Mar 1999 to Feb 2001. They were divided into two groups, 30 in diabetic group (Group I, 57.7+/-8.2 years, 22 male) and 89 in non-diabetic group (Group II, 59.6+/-10.8 years, 68 male). Early and long-term clinical outcomes after PCI were analyzed.
RESULTS
In clinical diagnosis the number of acute myocardial infarction was 25 in Group I (83.3%) and 76 in Group II (85.4%). As for risk factors and target lesion artery, ACC/AHA types, there were no differences between the two groups. The number of patients with total occlusion was 21 (55.3%) and 62 (53.9%) and thrombus-containing lesion 28 (93.3%) and 88 (98.9%) in Group I and II respectively. Procedure was successful in 27 (90.0%) in Group I and 80 (89.9%) in Group II and there were no differences in bleeding complications. No major adverse cardiac events (MACE), including myocardial infarction, repeat revascularization or cardiac death were observed in Group I, but there were 8 cases of MACE in Group II during hospitalization. Clinical follow-up was performed in 116 patients (97.5%) during 18.5+/-6.7 (5~28) months. The number of overall MACEs were 10 (3.3%) in Group I and 14 (15.7%) in Group II (p=0.038).
CONCLUSION
ReoPro(R)used in high-risk PCI in diabetics was effective in early clinical outcome, but long-term clinical benefits were not warranted.

Keyword

Platelets; Platelet aggregation; Diabetes; Acute Myocardial Infarction; Catheter-based coronary interventions

MeSH Terms

Arteries
Blood Platelets*
Death
Diagnosis
Follow-Up Studies
Glycoproteins*
Hemorrhage
Hospitalization
Humans
Jeollanam-do
Myocardial Infarction
Percutaneous Coronary Intervention*
Platelet Aggregation
Risk Factors
Glycoproteins