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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Published on: March 15, 2022

Safety of abciximab in patients with chronic renal insufficiency who are undergoing percutaneous coronary

Patricia J M Best1, Ryan Lennon, Bernard J Gersh

  • 1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.

American Heart Journal
|August 2, 2003
PubMed

Insights

Patients with chronic renal insufficiency (CRI) undergoing percutaneous coronary interventions (PCI) can safely receive abciximab. While CRI increases bleeding risk, abciximab does not significantly elevate this risk further in these patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Chronic renal insufficiency (CRI) is linked to poorer outcomes following percutaneous coronary interventions (PCI).
  • Abciximab, a drug used in PCI, may increase bleeding risk, particularly in patients with CRI.

Purpose of the Study:

  • To evaluate the safety of administering abciximab to patients with chronic renal insufficiency undergoing PCI.

Main Methods:

  • Analysis of 4158 patients undergoing PCI, categorized by creatinine clearance levels (<50 mL/min, 50-69 mL/min, ≥70 mL/min) or dialysis status.
  • Definition of major bleeding (cerebrovascular bleed or hematocrit decrease >15%) and minor bleeding (hematocrit decrease 10-15% with identifiable source).

Main Results:

  • Chronic renal insufficiency was associated with increased bleeding, both with and without abciximab use.
  • A trend towards interaction between creatinine clearance and major bleeding with abciximab was observed (OR, 1.18; P=.06).
  • No significant interaction was found for minor bleeding (OR, 1.01; P=.94) or any bleeding (OR, 1.10; P=.15) with abciximab in CRI patients.

Conclusions:

  • Chronic renal insufficiency independently increases the risk of bleeding complications after PCI.
  • Abciximab use is associated with increased bleeding risk, but this increase is not significantly amplified in patients with CRI.
  • Abciximab can be safely administered to patients with chronic renal insufficiency undergoing PCI.
Abstract

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