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Document type:
Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Article
Author(s):
Mehilli, J; Ndrepepa, G; Kastrati, A; Neumann, FJ; ten Berg, J; Bruskina, O; Dotzer, F; Seyfarth, M; Pache, J; Kufner, S; Dirschinger, J; Berger, PB; Schömig, A
Title:
Sex and effect of abciximab in patients with acute coronary syndromes treated with percutaneous coronary interventions: results from Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 2 trial.
Abstract:
BACKGROUND: It is not known whether there exists a sex-dependent difference in the clinical benefit of abciximab in patients with acute coronary syndromes (ACS) undergoing a percutaneous coronary intervention (PCI). METHODS: We performed this retrospective analysis of 2022 patients (498 women) with ACS enrolled in the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 2 trial and randomized to receive abciximab or placebo during a PCI procedure. The incidence of major adverse cardiac events (MACE) during the 30 days after PCI was the primary end point of the study. RESULTS: Among men, the 30-day incidence of MACE was 8.6% in the abciximab group compared with 12.6% in the placebo group, relative risk (RR) 0.69 (95% confidence interval [CI] 0.50-0.94), P = .01. The 30-day incidence of MACE in women was 9.7% in the abciximab group compared with 9.9% in the placebo group, RR 0.98 (95% CI, 0.56-1.72), P = .97. After adjustment for baseline clinical and angiographic characteristics, there was no significant interaction between sex and abciximab (P = .71); adjusted RR was 0.70 (95% CI, 0.34-1.34) in women and 0.60 (95% CI, 0.40-0.90) in men. The incidence of major bleeding was significantly greater in women (3.6%) than in men (0.7%), RR 5.5 (95% CI, 2.54-11.9), P < .001, without any dependence on the form of therapy received. CONCLUSIONS: In patients with non-ST elevation ACS undergoing a PCI, the benefit with abciximab is greater in men than in women. This is apparently the result of sex-based differences in risk profile.
Journal title abbreviation:
Am Heart J
Year:
2007
Journal volume:
154
Journal issue:
1
Pages contribution:
158.e1-7
Language:
eng
Fulltext / DOI:
doi:10.1016/j.ahj.2007.03.050
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/17584569
Print-ISSN:
0002-8703
TUM Institution:
I. Medizinische Klinik und Poliklinik (Kardiologie)
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