Clinical benefit of glycoprotein IIb/IIIa blockade with abciximab is independent of gender - Pooled analysis from EPIC, EPILOG and EPISTENT trials

OBJECTIVES We sought to determine the efficacy and safety of platelet glyco protein IIb/IIIa receptor (GP IIb/IIIa) blockade with abciximab in women un dergoing percutaneous coronary intervention. BACKGROUND Although gender differences in response to platelet glycoprotein IIb/IIIa receptor blockade have been described, there have been no large c linical studies to assess these differences. METHODS Outcomes were determined using meta-analysis technique. RESULTS In the pooled analysis, the primary end point of death, myocardial infarction (MI) or urgent revascularization within 30 days was reduced from 11.3% to 5.8% (p < 0.001) in men and from 12.7% to 6.5% (p < 0.001) in wom en treated with abciximab. At six months, death, MI or urgent revasculariza tion was reduced from 14.1% to 8.3% (p < 0.001) in men and 16.0% to 9.9% (p < 0.001) in women receiving abciximab. At one year, mortality was reduced from 2.7% to 1.9% (p = 0.06) in men and 4.0% to 2.5% (P = 0.03) in women tr eated with abciximab. Major bleeding events occurred in 2.9% versus 3.0% (p = 0.96) of women and 2.7% versus 1.3% (p = 0.003) of men treated with plac ebo versus abciximab, respectively. Minor bleeding events occurred in 4.7% versus 6.7% (p = 0.01) of women and 2.3% versus 2.2% (p = 0.94) of men trea ted with placebo Versus abciximab, respectively. CONCLUSIONS This pooled analysis demonstrated no gender difference in prote ction from major adverse outcomes with GP IIb/IIIa inhibition with abcixima b. Although women had higher rates of both major and minor bleeding events with abciximab compared with men, major bleeding in women was similar with and without abciximab. There was a small increased risk of minor bleeding w ith abciximab in women. (C) 2000 by the American College of Cardiology.