Related Experiment Video
Updated: Aug 15, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Costs and effects of combining stenting and abciximab (ReoPro) in daily practice
J E Zwart-van Rijkom1, O H Klungel, H G Leufkens
1Utrecht University, Department of Pharmaco-epidemiology and Pharmacotherapy, Utrecht, The Netherlands. J.E.F.Zwart-vanRijkom@pharm.uu.nl
Insights
Adding stents to abciximab treatment in percutaneous coronary intervention reduced major adverse cardiac events by 40% in clinical practice. This mirrors trial findings and incurs no additional costs, improving patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Economics
Background:
- The EPISTENT trial evaluated stents and abciximab in percutaneous coronary intervention (PCI).
- Trial findings may not generalize to real-world clinical practice.
- Assessing the effectiveness and cost-effectiveness of stenting with abciximab in a general patient population is crucial.
Purpose of the Study:
- To compare outcomes of stented versus non-stented patients undergoing angioplasty with abciximab in daily practice.
- To evaluate the clinical and economic impact of stent use in this setting.
- To compare these real-world findings with the EPISTENT trial results.
Main Methods:
- Prospective follow-up of 184 patients receiving abciximab for angioplasty from 1995-1999 in a Dutch regional hospital.
- Assessment of total costs and two composite clinical endpoints: death/myocardial infarction (MI) and death/MI/revascularization (major adverse cardiac events, MACE).
- Follow-up duration was 6 months post-procedure.
Main Results:
- Stented patients (N=101) had significantly lower MACE rates (6.9%) compared to non-stented patients (N=83) (16.9%; OR=0.37, P=0.04).
- Total costs were comparable between stented and non-stented groups (EUR 7,844 vs. EUR 7,904; P=0.93).
- The observed 44% relative risk reduction in MACE closely aligned with the EPISTENT trial's 42% reduction.
Conclusions:
- In routine clinical practice, combining stents with abciximab significantly reduces MACE.
- The observed risk reduction is consistent with findings from the EPISTENT trial.
- This strategy offers clinical benefits without increased healthcare costs.
Aim:
The combined use of stents and abciximab in percutaneous coronary intervention has been evaluated in the EPISTENT trial. However, the clinical and economic findings in trials are not necessarily generalisable to a general population setting. We conducted a study in daily clinical practice comparing stented and non-stented patients undergoing coronary angioplasty with abciximab administration. Furthermore, we compare our results with the findings of the EPISTENT trial.
Methods:
From 1995 to 1999, refractory unstable patients scheduled for angioplasty and receiving abciximab in a Dutch regional hospital were followed prospectively for 6 months. Total costs were considered in addition to 2 composite clinical endpoints: (1) death or myocardial infarction (MI); and (2) death, MI, or any revascularisation procedure (major adverse cardiac events, MACE).
Results:
Stented patients (N=101) experienced less MACE than non-stented patients (N=83) (6.9% vs. 16.9%, OR=0.37, P=0.04). The total costs were similar for stented and non-stented patients (EUR 7 844 vs. EUR 7 904, P=0.93). Adjustment for baseline characteristics yielded similar results, although significance subsided. The relative risk reduction of 44% that we found, closely resembles the 42% that was found in the EPISTENT trial.
Conclusions:
In everyday practice, as in the EPISTENT trial, the addition of a stent to abciximab treatment does seem to reduce the risk of MACE by about 40% at no additional costs.
