{"id":"dff8a3d6ddf1","type":"article","url":"https://hartvaat.nl/2016/08/16/intracoronair-abciximab-bij-diabetespatienten-met-primaire-pci-1-jaarsresultaten/","title":"Intracoronair abciximab bij diabetespatiënten met primaire PCI: 1-jaarsresultaten","title_en":"1-Year Outcomes With Intracoronary Abciximab in Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention.","category":"preventie","category_label":"Preventie","professions":["cardioloog"],"tags":["diabetes-en-hart","diabetes-type-1","diabetes-type-2","fidelio-dkd","figaro-dkd","soul-trial"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2016.05.078","source_url":"https://doi.org/10.1016/j.jacc.2016.05.078","authors":["Raffaele Piccolo","Ingo Eitel","Gennaro Galasso","Alberto Dominguez-Rodriguez","Allan Zeeberg Iversen","Pedro Abreu-Gonzalez","Stephan Windecker","Holger Thiele","Federico Piscione"],"significance":5,"published":"2016-08-16","source_date":"2016-08-16","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/cardiometabool/bloedsuikerdoelen-cardiovasculair/"],"congress":"","summary_en":"This study examined 1-year outcomes of intracoronary abciximab administration in diabetic STEMI patients undergoing primary PCI, testing targeted antiplatelet delivery for a high-risk population.","created":"2026-07-03T10:26:16Z","updated":"2026-07-03T13:25:37Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de 1-jaarsuitkomsten van intracoronaire abciximabtoediening bij diabetespatiënten die primaire PCI ondergaan. Onderzoekt of lokale GPIIb/IIIa-blokkade voordelen biedt boven systemische toediening.","abstract_original":"BACKGROUND: Diabetic patients are at increased risk for future cardiovascular events after ST-segment elevation myocardial infarction (STEMI). Administration of an intracoronary abciximab bolus during primary percutaneous coronary intervention (PCI) may be beneficial in this high-risk subgroup. OBJECTIVES: This study sought to report the 1-year clinical outcomes and cardiac magnetic resonance (CMR) findings in STEMI patients with and without diabetes randomized to intracoronary or intravenous abciximab bolus at the time of primary PCI. METHODS: Patient-level data from 3 randomized trials were pooled. The primary endpoint was the composite of death or reinfarction. Comprehensive CMR imaging was performed in 1 study. RESULTS: Of 2,470 patients, 473 (19%) had diabetes and 1,997 (81%) did not. At 1 year, the primary endpoint was significantly reduced in diabetic patients randomized to intracoronary abciximab compared with those randomized to intravenous bolus (9.2% vs. 17.6%; hazard ratio [HR]: 0.49; 95% confidence interval [CI]: 0.28 to 0.83; p = 0.009). The intracoronary abciximab bolus did not reduce the primary endpoint in patients without diabetes (7.4% vs. 7.5%; HR: 0.95; 95% CI: 0.68 to 1.33; p = 0.77), resulting in a significant interaction (p = 0.034). Among diabetic patients, intracoronary versus intravenous abciximab bolus was associated with a significantly reduced risk of death (5.8% vs. 11.2%; HR: 0.51; 95% CI: 0.26 to 0.98; p = 0.043) and definite/probable stent thrombosis (1.3% vs. 4.8%; HR: 0.27; 95% CI: 0.08 to 0.98; p = 0.046). At CMR (n = 792), the myocardial salvage index was significantly increased only in diabetic patients randomized to intracoronary compared with intravenous abciximab (54.4; interquartile range: 35.1 to 78.2 vs. 39.0, interquartile range: 24.7 to 61.7; p = 0.011; p for interaction vs. no diabetes = 0.016). CONCLUSIONS: In diabetic patients with STEMI, the administration of intracoronary abciximab improved the effectiveness of primary PCI compared with the intravenous bolus."}