1-Year Outcomes With Intracoronary Abciximab in Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention

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dc.contributor.author Piccolo, Raffaele
dc.contributor.author Eitel, Ingo
dc.contributor.author Galasso, Gennaro
dc.contributor.author Domínguez Rodríguez, Alberto 
dc.contributor.author Iversen, Allan Zeeberg
dc.contributor.author Abreu González, Pedro
dc.contributor.author Windecker, Stephan
dc.contributor.author Thiele, Holger
dc.contributor.author Piscione, Federico
dc.date.accessioned 2017-12-07T10:06:14Z
dc.date.available 2017-12-07T10:06:14Z
dc.date.issued 2016
dc.identifier.citation Piccolo, R., Eitel, I., Galasso, G., Dominguez-Rodriguez, A., Iversen, A. Z., Abreu-Gonzalez, P., ... & Piscione, F. (2016). 1-year outcomes with intracoronary abciximab in diabetic patients undergoing primary percutaneous coronary intervention. Journal of the American College of Cardiology, 68(7), 727-738. spa
dc.identifier.issn 0735-1097
dc.identifier.uri http://hdl.handle.net/11268/6828
dc.description.abstract BACKGROUND: Diabetic patients are at increased risk for future cardiovascular events after ST-segment elevation myocardial infarction (STEMI). Administration of an intracoronary abciximab bolus during primary percutaneous coronary intervention (PCI) may be beneficial in this high-risk subgroup. OBJECTIVES: This study sought to report the 1-year clinical outcomes and cardiac magnetic resonance (CMR) findings in STEMI patients with and without diabetes randomized to intracoronary or intravenous abciximab bolus at the time of primary PCI. METHODS: Patient-level data from 3 randomized trials were pooled. The primary endpoint was the composite of death or reinfarction. Comprehensive CMR imaging was performed in 1 study. RESULTS: Of 2,470 patients, 473 (19%) had diabetes and 1,997 (81%) did not. At 1 year, the primary endpoint was significantly reduced in diabetic patients randomized to intracoronary abciximab compared with those randomized to intravenous bolus (9.2% vs. 17.6%; hazard ratio [HR]: 0.49; 95% confidence interval [CI]: 0.28 to 0.83; p = 0.009). The intracoronary abciximab bolus did not reduce the primary endpoint in patients without diabetes (7.4% vs. 7.5%; HR: 0.95; 95% CI: 0.68 to 1.33; p = 0.77), resulting in a significant interaction (p = 0.034). Among diabetic patients, intracoronary versus intravenous abciximab bolus was associated with a significantly reduced risk of death (5.8% vs. 11.2%; HR: 0.51; 95% CI: 0.26 to 0.98; p = 0.043) and definite/probable stent thrombosis (1.3% vs. 4.8%; HR: 0.27; 95% CI: 0.08 to 0.98; p = 0.046). At CMR (n = 792), the myocardial salvage index was significantly increased only in diabetic patients randomized to intracoronary compared with intravenous abciximab (54.4; interquartile range: 35.1 to 78.2 vs. 39.0, interquartile range: 24.7 to 61.7; p = 0.011; p for interaction vs. no diabetes = 0.016). CONCLUSIONS: In diabetic patients with STEMI, the administration of intracoronary abciximab improved the effectiveness of primary PCI compared with the intravenous bolus. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title 1-Year Outcomes With Intracoronary Abciximab in Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention spa
dc.type article spa
dc.description.impact 19.896 JCR (2016) Q1, 2/126 Cardiac & Cardiovascular Systems spa
dc.identifier.doi 10.1016/j.jacc.2016.05.078
dc.rights.accessRights openAccess spa
dc.subject.uem Cardiología spa
dc.subject.uem Diabetes spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.description.filiation UEC spa
dc.relation.publisherversion http://dx.doi.org/10.1016/j.jacc.2016.05.078 spa
dc.peerreviewed Si spa

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