Abstract 3799: Age-Dependent Effect of Abciximab in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Interventions
No studies have specifically performed an age-based analysis of the efficacy of abciximab in patients with non-ST-segment elevation acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). The aim of this retrospective analysis was to assess whether there are age-dependent differences in the clinical benefit of abciximab in patients with ACS treated with PCI. Method and
Results: Of 2022 patients with ACS enrolled in the ISAR-REACT 2 study and randomized to receive abciximab or placebo during a PCI procedure, 1013 were younger and 1009 were older than the median age of 67 years. The incidence of major adverse cardiac events (MACE) during the 30 days after PCI was the primary end point of the study. Among younger patients, MACE occurred in 34 patients (6.4%) in the group with abciximab versus 64 patients (13.3%) in the group with placebo; relative risk (RR) 0.47, 95% confidence interval (CI) 0.31 to 0.71, P<0.001. In contrast, among older patients, MACE occurred in 56 patients (11.6%) randomized to receive abciximab and 56 patients (10.6%) randomized to receive placebo; RR 1.2, 95% CI 0.6 to 2.6, P=0.62. There was a significant interaction between age and abciximab (P=0.004), with abciximab having a greater efficacy in younger patients than in older patients in terms of a reduction in the 30-day incidence of MACE even after adjustment for other variables including cardiac troponin.
Conclusions: In patients with ACS undergoing percutaneous coronary intervention, the efficacy of abciximab appears to be age dependent, being beneficial only in younger patients.