Document Detail


Glycoprotein IIb/IIIa receptor inhibition with abciximab during percutaneous coronary interventions increases the risk of bleeding in patients with impaired renal function.
MedLine Citation:
PMID:  18434733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Whether patients with renal insufficiency (RI) undergoing percutaneous coronary interventions (PCI) benefit from abciximab added to clopidogrel plus aspirin is unknown.
METHODS: The study included 2,159 patients with coronary artery disease undergoing elective PCI. RI was assessed using glomerular filtration rate (GFR) cutoff values: moderate-to-severe RI (GFR <or=60 ml/min), mild RI (GFR >60 to <or=90 ml/min) and no RI (GFR >90 ml/min). The 30-day incidence of major adverse cardiac events (MACE) and bleeding were the primary outcome analyses.
RESULTS: In patients with moderate-to-severe RI, mild RI and no RI, MACE occurred in 5.2, 5 and 2.9%, respectively, in the abciximab group (p = 0.14) and in 4.2, 3.8 and 4.0%, respectively, in the placebo group (p = 0.96). In the abciximab group, bleeding complications occurred in 8.9% of patients with moderate-to-severe RI, in 2.0% with mild RI and in 2.1% with no RI (p < 0.001). Multivariable analysis identified GFR as an independent correlate of MACE (p = 0.03) and bleeding (p = 0.001) with a trend for an interaction between GFR and abciximab regarding major bleeding (p = 0.22).
CONCLUSIONS: In patients with RI undergoing PCI, adding abciximab to clopidogrel plus aspirin increases the risk of bleeding without benefit in reducing the risk of ischemic complications within the first 30 days.
Authors:
Tobias Pinkau; Gjin Ndrepepa; Adnan Kastrati; Johannes F E Mann; Stefanie Schulz; Julinda Mehilli; Albert Schömig
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-23
Journal Detail:
Title:  Cardiology     Volume:  111     ISSN:  1421-9751     ISO Abbreviation:  Cardiology     Publication Date:  2008  
Date Detail:
Created Date:  2008-10-31     Completed Date:  2009-01-23     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  247-53     Citation Subset:  IM    
Copyright Information:
Copyright 2008 S. Karger AG, Basel.
Affiliation:
Deutsches Herzzentrum und Medizinische Klinik rechts der Isar, Technische Universitat und Medizinische Abteilung fur Nieren- und Hochdruckerkrankungen, Stadtisches Krankenhaus Munchen-Schwabing, Munchen, Deutschland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary*
Antibodies, Monoclonal / administration & dosage,  adverse effects*
Aspirin / administration & dosage,  adverse effects
Coronary Artery Disease / complications,  drug therapy*,  mortality,  therapy
Drug Therapy, Combination
Female
Germany
Glomerular Filtration Rate
Hemorrhage / chemically induced
Humans
Immunoglobulin Fab Fragments / administration & dosage,  adverse effects*
Male
Middle Aged
Multivariate Analysis
Platelet Aggregation Inhibitors / administration & dosage,  adverse effects*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Questionnaires
Renal Insufficiency / complications*,  mortality
Retrospective Studies
Survival Analysis
Ticlopidine / administration & dosage,  adverse effects,  analogs & derivatives
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; X85G7936GV/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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