Key result
Abciximab at the time of coronary stent implantation did not reduce in-stent intimal hyperplasia volume at 6 months compared to no abciximab in diabetic patients (41.3% vs 40.5%; P=0.9).
Why the study?
Does abciximab reduce in-stent intimal hyperplasia in type 2 diabetic patients undergoing elective stent implantation?
RCT (n=96)
Does abciximab reduce in-stent intimal hyperplasia in type 2 diabetic patients undergoing elective stent implantation?
Absolute Event Rate: 41.3% vs 40.5%
p-value: p=0.9
Abciximab administration during coronary stenting does not reduce in-stent intimal hyperplasia in diabetic patients.
Abciximab should not be used to prevent in-stent intimal hyperplasia in diabetic stent patients; confirms lack of efficacy on primary endpoint.
BACKGROUND: In diabetic patients in the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting (EPISTENT) trial, abciximab reduced target vessel revascularization by approximately 50% compared with placebo. Whether this is a result of a lower restenosis rate caused by inhibition of intimal hyperplasia remains to be defined. METHODS AND RESULTS: The purpose of this study was to determine whether abciximab at the time of stent implantation would reduce in-stent intimal hyperplasia measured by intravascular ultrasound at 6-month follow-up in type 2 diabetics. Ninety-six diabetic patients (96 lesions) who underwent elective stent implantation for a de novo lesion in a native coronary artery were randomly assigned to receive abciximab or no abciximab. In-stent intimal hyperplasia volume, expressed as percentage of stent volume, did not differ between groups: 41.3+/-21.0% for those treated with abciximab versus 40.5+/-18.3% for those treated without abciximab (P=0.9). There were also no significant differences in angiographic minimal luminal diameter at follow-up (1.74+/-0.69 versus 1.66+/-0.63 mm; P=0.5), late loss (1.03+/-0.63 versus 1.07+/-0.58 mm; P=0.7), restenosis rate (17.8% versus 22.9%; P=0.5), or cumulative incidence of major adverse cardiac events at 12 months (19.1% versus 20.4%; P=0.9). CONCLUSIONS: Six-month intravascular ultrasound volumetric analysis showed that abciximab, at the time of coronary stent implantation, was not associated with a reduction of in-stent intimal hyperplasia in diabetic patients.
No takes yet. Share an insight, caveat, or question.
Chaves et al. (2004) conducted an RCT in Type 2 diabetes with de novo coronary artery lesions (n=96). Abciximab vs. No abciximab was evaluated on In-stent intimal hyperplasia volume, expressed as percentage of stent volume at 6 months (p=0.9). Abciximab at the time of coronary stent implantation did not reduce in-stent intimal hyperplasia volume at 6 months compared to no abciximab in diabetic patients (41.3% vs 40.5%; P=0.9).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: