Impact of platelet glycoprotein IIb/IIIa receptor inhibitors on outcomes of diabetic patients undergoing percutaneous coronary interventions using sirolimus-eluting stents

Eugenia Nikolsky, David R. Holmes, Roxana Mehran, George Dangas, Erick Schampaert, Marie Claude Morice, Joachim Schofer, J. Eduardo Sousa, Martin Fahy, Yingbo Na, Dennis J. Donohoe, Jeffrey W. Moses, Martin B. Leon

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Abstract

Objective: We assessed the outcomes in diabetic patients undergoing percutaneous coronary intervention (PCI) using sirolimus-eluting stents (SES) as a function of treatment with glycoprotein (GP) llb/llla inhibitors. Methods and Results: Of 551 diabetic patients treated with a SES in nine trials (RAVEL, SIRIUS, E-SIRIUS, C-SIRIUS, REALITY, SVELTE, DIRECT, SIRIUS 2.25, and SIRIUS 4.0), 187 patients (33.9%) were administered GP llb/llla inhibitors during PCI. GP llb/llla blockade was associated with lower rates of myocardial infarction (Ml) at 30 days (1.1% vs. 3.3%, P = 0.12) and at 1 year (1.1% vs. 4.7%, P = 0.04), and composite endpoint of cardiac death/Ml at 1 year (2.2% vs. 6.2%, P = 0.05). Benefit from GP llb/llla inhibitors was confined to 128 insulin-treated diabetics who had remarkable reduction in Ml (0.0% vs. 6.3%, P = 0.04) and cardiac death/Ml at 30 days (0.0% vs. 7.6%, P = 0.05) and at 1-year (0.0% vs. 13.4%, P = 0.01 and 0.0% vs. 15.7%, P = 0.0005, respectively). When treated with GP llb/llla inhibitors, insulin-requiring diabetics had similar rates of 1-year death/Ml when compared with the nondiabetic patients (0% vs. 4.7%, P = 0.13, respectively). There were no significant differences in outcomes as a function of GP llb/llla blockade in diabetics not treated with insulin. Conclusion: In this analysis, outcomes of insulin requiring diabetic patients undergoing PCI with SES were considerably improved with adjunctive GP llb/llla inhibitors by decreasing the rates of Ml and composite endpoint of cardiac death/Ml.

Original languageEnglish (US)
Pages (from-to)896-906
Number of pages11
JournalCatheterization and Cardiovascular Interventions
Volume71
Issue number7
DOIs
StatePublished - Jun 1 2008

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Nikolsky, E., Holmes, D. R., Mehran, R., Dangas, G., Schampaert, E., Morice, M. C., Schofer, J., Sousa, J. E., Fahy, M., Na, Y., Donohoe, D. J., Moses, J. W., & Leon, M. B. (2008). Impact of platelet glycoprotein IIb/IIIa receptor inhibitors on outcomes of diabetic patients undergoing percutaneous coronary interventions using sirolimus-eluting stents. Catheterization and Cardiovascular Interventions, 71(7), 896-906. https://doi.org/10.1002/ccd.21548