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document
Impact of different platelet glycoprotein IIb/IIIa receptor inhibitors among diabetic patients undergoing percutaneous coronary intervention : : Do Tirofiban and ReoPro Give Similar Efficacy Outcomes Trial ( TARGET ) 1-year follow-up . BACKGROUND The platelet glycoprotein IIb/IIIa receptor inhibitor abciximab , a monoclonal antibody , has been shown to improve early and late outcomes among diabetic patients undergoing percutaneous coronary intervention ( PCI ) . It is unknown whether small-molecule agents confer similar benefits . METHODS AND RESULTS In 18 countries , 4809 patients undergoing PCI with stent implantation were randomized to tirofiban or abciximab . At the time of enrollment , patients were stratified according to diabetes status . As compared with non-diabetic patients , patients with diabetes ( n=1117 ) showed similar 30-day ischemic outcomes , an increased incidence of any target vessel revascularization ( TVR ) at 6 months ( 10.3 % versus 7.8 % ; P= 0.008 ) , and a trend toward higher 1-year mortality ( 2.5 % versus 1.6 % ; P=0.056 ) . Among diabetic patients randomized to tirofiban ( n=560 ) , the incidence of death , myocardial infarction ( MI ) , or urgent TVR at 30 days was 6.2 % , and among those randomized to abciximab ( n=557 ) it was 5.4 % ( hazard ratio [ HR ] 1.16 ; P=0.540 ) . At 6 months , the composite of death , MI , or any TVR occurred in 15.7 % and in 16.9 % of tirofiban and abciximab patients , respectively ( HR 0.93 ; P=0.610 ) . Any TVR occurred in 9.5 % and 11.1 % , respectively ( HR 0.84 ; P= 0.366 ) . The 1-year mortality was 2.1 % in the tirofiban group and 2.9 % in the abciximab group ( HR 0.74 ; P= 0.436 ) . CONCLUSIONS Among diabetic patients undergoing PCI , tirofiban and abciximab were associated with comparable event rates , including similar rates of 6-month TVR and 1-year mortality . These findings suggest that the non-glycoprotein IIb/IIIa properties of abciximab do not translate into a discernible long-term clinical benefit among diabetic patients .
9405
Intervention_Pharmacological
tirofiban
9406
Intervention_Pharmacological
abciximab
9407
Outcome_Physical
incidence of any target vessel revascularization ( TVR
9408
Outcome_Mortality
higher 1-year mortality
9409
Outcome_Mortality
death
9410
Outcome_Physical
myocardial infarction ( MI ) ,
9411
Outcome_Physical
urgent TVR
9412
Outcome_Mortality
death
9413
Outcome_Physical
TVR
9414
Outcome_Physical
TVR
9415
Outcome_Mortality
1-year mortality
9416
Participant_Condition
diabetic
9417
Participant_Condition
percutaneous coronary intervention
9418
Participant_Sample-size
4809
9419
Participant_Condition
stent implantation
9420
Participant_Condition
diabetic patients undergoing PCI