Abstract
Despite numerous technical advances in recent years, percutaneous coronary intervention (PCI) in patients with chronic renal insufficiency is associated with poor long-term outcome compared with the general population. 1 Ting H.H. Tahirkheli N.K. Berger P.B. McCarthy J.T. Timimi F.K. Mathew V. Rihal C.S. Hasdai D. Holmes Jr, D.R. Evaluation of long-term survival after successful percutaneous coronary intervention among patients with chronic renal failure. Am J Cardiol. 2001; 87: 630-633 Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar The inhibition of the final common pathway of platelet aggregation by glycoprotein IIb/IIIa inhibitors during PCI has been shown to significantly reduce short- and long-term adverse cardiovascular end points in multiple studies. 2 The EPIC InvestigatorsUse of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty. The EPIC Investigation. N Engl J Med. 1994; 330: 956-961 Crossref PubMed Scopus (2675) Google Scholar , 3 The EPILOG InvestigatorsPlatelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization. N Engl J Med. 1997; 336: 1689-1696 Crossref PubMed Scopus (1968) Google Scholar , 4 IMPACT-II InvestigatorsRandomised placebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention IMPACT-II. Integrilin to Minimise Platelet Aggregation and Coronary Thrombosis-II. Lancet. 1997; 349: 1422-1428 Abstract Full Text Full Text PDF PubMed Scopus (872) Google Scholar , 5 The EPISTENT InvestigatorsRandomised placebo-controlled and balloon-angioplasty-controlled trial to assess safety of coronary stenting with use of platelet glycoprotein- IIb/IIIa blockade. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting. Lancet. 1998; 352: 87-92 Crossref PubMed Google Scholar Patients with impaired renal function were excluded from most trials using glycoprotein IIb/IIIa inhibitors because there is concern about increased bleeding risk in this patient population. Therefore, the safety and efficacy of glycoprotein IIb/IIIa inhibitors in patients with chronic renal insufficiency is not well established. The present study evaluates bleeding risk and assesses the impact of abciximab therapy on outcome in patients with chronic renal insufficiency who underwent PCI.
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