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Abciximab in elderly with acute coronary syndrome invasively treated: effect on outcome
- Publication Year :
- 2008
-
Abstract
- Older age is an independent predictor of mortality after percutaneous coronary intervention (PCI) in patients with Non-ST elevation Acute Coronary Syndrome (ACS). GPIIb/IIIa inhibitors are proved to improve outcome in high risk patients, but conflicting data are available about the effects of these inhibitors in elderly. Accordingly, we studied a consecutive population of elderly patients undergoing PCI for Non-ST elevation ACS. A total of 500 patients were divided in: GPI group (247 pts; mean age 77±1.9 years) treated by stenting plus abciximab and, no GPI group (253 pts; mean age 77±2.4 years) treated by stenting alone. Propensity analysis was used to account for the nonrandomized use of GPIIb/IIIa inhibitors. During hospitalization, incidence of death was similar among groups (3.2% vs 4.6%) without difference regarding incidence of major (1.6% vs 1.1%) and minor bleedings (4% vs 3%). At long-term follow-up the rate of death was significantly lower in GPI group (4.5% vs 12.3%; p =0.002) as well as the rate of acute myocardial infarction (2.8% vs 11.1%; p =0.0001), and pre-PCI (5.7% vs 13.4%; p =0.003). Cox regression analysis identified abciximab use as an independent predictor of lower long-term major adverse cardiac event (MACE) after adjustment for propensity score (Exp (B) 0.620, 95%CI 0.394–0.976, p =0.039). Our results suggest that addition of abciximab to stenting improves outcome in elderly patients with Non-ST elevation ACS, leading to an absolute benefit for reduction of death and MACE, with an acceptable rate of major and minor bleedings.
- Subjects :
- Male
medicine.medical_specialty
Acute coronary syndrome
medicine.medical_treatment
Abciximab
Population
Hemorrhage
Platelet Glycoprotein GPIIb-IIIa Complex
Disease-Free Survival
Immunoglobulin Fab Fragments
Risk Factors
Internal medicine
Angioplasty
medicine
Humans
Myocardial infarction
Acute Coronary Syndrome
Angioplasty, Balloon, Coronary
education
Aged
education.field_of_study
business.industry
Percutaneous coronary intervention
Antibodies, Monoclonal
medicine.disease
Combined Modality Therapy
Treatment Outcome
Conventional PCI
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Mace
Platelet Aggregation Inhibitors
medicine.drug
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....e8c31fe417f11b75c20af66e3e7377d3