| Glycoprotein IIb/IIIa receptor inhibition with abciximab during percutaneous coronary interventions increases the risk of bleeding in patients with impaired renal function. | |
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MedLine Citation:
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PMID: 18434733 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Tobias Pinkau; Gjin Ndrepepa; Adnan Kastrati; Johannes F E Mann; Stefanie Schulz; Julinda Mehilli; Albert Schömig |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-04-23 |
Journal Detail:
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Title: Cardiology Volume: 111 ISSN: 1421-9751 ISO Abbreviation: Cardiology Publication Date: 2008 |
Date Detail:
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Created Date: 2008-10-31 Completed Date: 2009-01-23 Revised Date: 2013-05-24 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 247-53 Citation Subset: IM |
Copyright Information:
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Copyright 2008 S. Karger AG, Basel. |
Affiliation:
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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:
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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:
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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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