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Published on: March 12, 2018

Abciximab in elderly with acute coronary syndrome invasively treated: effect on outcome

Gennaro Galasso1, Federico Piscione, Fulvio Furbatto

  • 1Division of Cardiology, Federico II University, Naples, Italy.

International Journal of Cardiology
|July 2, 2008
PubMed

Insights

Adding abciximab (a GPIIb/IIIa inhibitor) to stenting significantly reduces long-term death and major adverse cardiac events in elderly patients with Non-ST elevation Acute Coronary Syndrome (ACS). This treatment offers an absolute benefit with acceptable bleeding risk.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Older age is a significant risk factor for mortality following percutaneous coronary intervention (PCI) in Non-ST elevation Acute Coronary Syndrome (ACS).
  • The role of GPIIb/IIIa inhibitors in elderly ACS patients undergoing PCI remains debated due to conflicting data.

Purpose of the Study:

  • To evaluate the efficacy and safety of adding abciximab (a GPIIb/IIIa inhibitor) to stenting in elderly patients with Non-ST elevation ACS.
  • To assess the long-term impact of abciximab on mortality and major adverse cardiac events (MACE) in this high-risk population.

Main Methods:

  • A consecutive cohort of 500 elderly patients with Non-ST elevation ACS undergoing PCI was analyzed.
  • Patients were divided into two groups: those treated with stenting plus abciximab (GPI group) and those treated with stenting alone (no GPI group).
  • Propensity score analysis was employed to adjust for non-randomized treatment allocation.

Main Results:

  • In-hospital mortality and bleeding rates were similar between the GPI and no GPI groups.
  • Long-term follow-up revealed significantly lower rates of death (4.5% vs 12.3%), myocardial infarction (2.8% vs 11.1%), and pre-PCI events (5.7% vs 13.4%) in the GPI group.
  • Cox regression identified abciximab use as an independent predictor of reduced long-term MACE (Exp(B) 0.620).

Conclusions:

  • The addition of abciximab to stenting improves long-term outcomes in elderly patients with Non-ST elevation ACS.
  • This strategy leads to a significant reduction in death and MACE with a manageable bleeding profile.
  • Abciximab administration is associated with improved long-term MACE in this patient cohort.

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