Effect of Abciximab on late adverse events in patients with diabetes mellitus undergoing stent implantation

Percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) is associated with higher rates of adverse cardiac events. Recent dat a suggest that adverse events are reduced in DM after PCI using stents with abciximab. We performed a retrospective analysis of a prospective PCI regi stry for all patients with DM who underwent stent placement at the Mayo Cli nic from 1995 to 1997 (n = 570), and divided them into 2 groups based on wh ether abciximab was administered. Characterization and comparison of the cl inical and angiographic variables, procedural outcomes, and short- and long -term event rates between groups was performed. The baseline clinical chara cteristics of the groups were similar, but patients treated with abciximab were more likely to be men with a lower left ventricular ejection fraction. Patients treated with abciximab had more multivessel intervention, sapheno us vein graft intervention, and thrombus before intervention. The 30-day mo rtality rate (0.6% vs 3.0%, p = 0.03) and repeat PCI (0% vs 1.1%, p = 0.03) was lower in patients treated with abciximab. The 30-day rates of bypass s urgery, myocardial infarction (MI), and a composite of death, MI, and revas cularization were similar. The I-year event rates did not differ significan tly between patients taking and not taking abciximab for the end points of death (8.9% vs 8.8%, p = 0.97), MI (13.3% vs 11.4%, p 0.57), bypass surgery (10.3% vs 6.2%, p = 0.20), repeat PCI (14.7% vs 15.9%, p = 0.76), and a co mposite of death, MI, and revascularization (30.4% vs 26.7%, p = 0.43). Aft er adjusting for baseline variables, abciximab did not influence the occurr ence of late adverse events. (C) 2000 by Excerpta Medica, inc.