Comparison of efficacy and complication rates after percutaneous coronary interventions in patients with and without renal insufficiency treated with abciximab

Frilling, Birgit; Zahn, Ralf; Fraiture, Boris; Mark, Bernd; Dönges, Klaus; Becker, Torsten; Siegler, Karl Ernst; Seidl, Karlheinz; Rustige, Jörg; Senges, Jochen

doi:10.1016/s0002-9149(01)02267-6

Cited by 27 publications

(14 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although abciximab increases the risk of bleeding in all patients submitted to revascularization, there have been some inconsistencies among studies concerning whether the increase in relative risk is significantly greater in patients with CKD. [102][103][104] In pooled data from abciximab trials, however, there was no difference in the rates of all major bleeding and the 30-day primary end point of death, MI, or urgent intervention in patients with CKD between the abciximab and placebo groups. 105 With tirofiban, the pivotal trials evaluating efficacy and safety excluded patients with serum creatinine Ͼ2.5 mg/dL.…”

Section: Gpiib/iiia Inhibitorsmentioning

confidence: 96%

Antithrombotic Therapy in Patients With Chronic Kidney Disease

2012

View full text Add to dashboard Cite

Section: Gpiib/iiia Inhibitorsmentioning

confidence: 96%

Antithrombotic Therapy in Patients With Chronic Kidney Disease

2012

View full text Add to dashboard Cite

“…8 From the limited data available, despite dosage adjustment of glycoprotein IIb/IIIa inhibitors, the risk of bleeding increases with decreasing renal function. 34 In a small group of patients, Frilling et al 35 found a nonsignificant trend of increased mortality in the RI group when abciximab was used during PCI. Post hoc analysis of the results of the ESPRIT (Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy) trial 36 demonstrated that the beneficial effect of glycoprotein IIb/IIIa inhibitors on short-term outcomes after PCI was greater in patients with mild RI than in those with severe RI.…”

Section: Adjunctive Therapy Usementioning

confidence: 98%

Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

El‐Menyar

Suwaidi

Holmes

2010

Mayo Clinic Proceedings

View full text Add to dashboard Cite

Renal insufficiency (RI) has been shown to be associated with increased major adverse cardiovascular events after percutaneous coronary intervention. We reviewed the impact of RI on the pathogenesis of coronary artery disease and outcomes after percutaneous coronary intervention in the form of drug-eluting stent (DES) implantation in these high-risk patients. We searched the English-language literature indexed in MEDLINE, Scopus, and EBS-CO Host research databases from 1990 through January 2009, using as search terms coronary revascularization, drug-eluting stent, and renal insufficiency. Studies that assessed DES implantation in patients with various degrees of RI were selected for review. Most of the available data were extracted from observational studies, and data from randomized trials formed the basis of a post hoc analysis. The outcomes after coronary revascularization were less favorable in patients with RI than in those with normal renal function. In patients with RI, DES implantation yielded better outcomes than did use of bare-metal stents. Randomized trials are needed to define optimal treatment of these high-risk patients with coronary artery disease. © 2010 Mayo Foundation for Medical Education and ResearchR enal insufficiency (RI), defined as creatinine clearance lower than or equal to 60 mL/min, is prevalent in patients with coronary artery disease (CAD). [1][2][3][4][5] In patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI), even mild RI is an independent predictor of worse outcomes.1 Renal insufficiency is a potent risk factor for CAD and qualifies as a coronary risk equivalent. Chronic RI not only increases cardiovascular event risk but also is associated with worse outcomes if an event occurs. 6 Diagnostic coronary angiography and PCI are used less frequently in patients with reduced renal function; risk of complications from these procedures is increased in the presence of RI. 7,8 This increased risk has been shown to occur at even moderate levels of RI, despite the use of advanced stent technology and optimal adjunctive medical therapy. Best et al 10 reported an RI prevalence of 49.1% in patients undergoing elective PCI. In that study, RI had a negative impact similar to that of diabetes mellitus (DM) on cardiovascular outcomes.10 One year after PCI, chronic RI was associated with a doubling of mortality in patients with mild RI, a 5-fold increase in patients with moderate RI, and a 12-fold increase in patients with severe RI. 10 In primary PCI for myocardial infarction (MI), a notable incremental reduction in survival was evident for each decline of 10 mL/min in creatinine clearance.11 Unfortunately, most randomized trials of patients undergoing PCI have excluded patients with severe RI. 12,13 This narrative review aims to identify the impact of a drug-eluting stent (DES) in the performance of PCI in patients with RI. METHODSWe evaluated the impact of RI on the pathogenesis of CAD and outcomes after PCI (in the form of DES implantation) in these high...

show abstract

“…patients undergoing PCI who received abciximab. 60 Of the 1040 patients included, 44 were classified as having renal insufficiency. The authors reported no significant differences in the rates of in-hospital mortality or nonfatal major adverse cardiac events among patients with renal insufficiency compared with those without, although major bleeding occurred more frequently among patients with renal insufficiency (4.5% versus 0.6%; P=0.003).…”

Section: Major Bleeding Minor Bleedingmentioning

confidence: 99%