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Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
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Late outcomes after intervention of vein grafts in diabetics with abciximab use

Robert J Applegate1, Bharathi Upadhya, William C Little

  • 1Section of Cardiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA. bapplga@wfubmc.edu

International Journal of Cardiology
|October 18, 2005
PubMed

Insights

Routine abciximab use in diabetic patients undergoing saphenous vein graft percutaneous coronary intervention showed similar late outcomes compared to non-diabetics. This suggests glycoprotein IIb/IIIa inhibitors may mitigate diabetes-related adverse effects in these procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Diabetes mellitus is a significant risk factor for adverse long-term outcomes following percutaneous coronary intervention (PCI), including procedures involving saphenous vein grafts (SVGs).
  • Glycoprotein IIb/IIIa inhibitors have demonstrated benefits in reducing adverse events in native coronary artery PCI for diabetic patients.
  • The impact of these inhibitors on diabetic patients undergoing SVG PCI remains largely unknown.

Purpose of the Study:

  • To evaluate the late clinical outcomes of elective percutaneous coronary interventions for saphenous vein grafts in diabetic patients.
  • To assess the role of abciximab, a glycoprotein IIb/IIIa inhibitor, in mitigating potential adverse outcomes associated with diabetes in SVG PCI.

Main Methods:

  • A cohort of 509 elective SVG PCI procedures was analyzed.
  • Glycoprotein IIb/IIIa inhibitors, primarily abciximab, were utilized in 99% of cases.
  • Clinical follow-up, averaging 30 months, was obtained for 93% of patients.

Main Results:

  • Procedural success rates were high (97%) and comparable between diabetic and non-diabetic patients.
  • Major adverse cardiac events (MACE) during the procedure and late MACE rates were similar for both groups (late MACE: 57.6% in diabetics vs. 54.9% in non-diabetics).
  • Graft age and the presence of thrombus were identified as independent predictors of increased late MACE.

Conclusions:

  • Routine use of abciximab in SVG PCI appears to attenuate the historically observed adverse long-term outcomes in diabetic patients.
  • Late clinical outcomes following SVG PCI with abciximab were similar between diabetic and non-diabetic individuals.
  • Selective use of glycoprotein IIb/IIIa inhibitors should be considered for diabetic patients undergoing SVG PCI.
Abstract

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