NEW YORK, Mar 15 (Reuters Health) -- While diabetics currently face
higher-than-average odds of dying after certain heart procedures, researchers
have discovered that an anti-clotting drug called abciximab can cut diabetics'
death rate to the level of those without the disease.
Among nearly 1,500 diabetics who underwent artery-clearing angioplasty,
those who received abciximab during the procedure were 44% less likely than
those on an inactive placebo to die within a year of surgery, according to Dr.
Eric J. Topol and colleagues at the Cleveland Clinic Foundation in Ohio.
Overall, 4.5% of diabetics died within a year of the procedure compared with
2.5% of diabetic patients who were given abciximab. The drug also brought
high-risk patients -- those who were diabetic, obese and had high blood pressure
-- a 25% drop in the combined risk for death, heart attack, or repeat procedure.
In this group, 2.3% on abciximab died within a year, compared with 5.1% given
placebo
Among insulin-dependent diabetics -- who have been shown to have a higher
death rate after heart procedures than those not on insulin -- abciximab
patients had a 4.2% rate of death, compared with 8.1% for placebo patients.
The researchers combined the results of three trials including 6,500
diabetic and non-diabetic heart disease patients given either abciximab or a
placebo. Their findings are published in the March 15th issue of the Journal of
the American College of Cardiology.
In the trials, some patients underwent balloon angioplasty, in which a
balloon-tipped catheter is snaked into heart arteries to press fatty plaques
against the artery walls. Others had angioplasty in combination with placement
of stents -- tiny structures that are placed in arteries to keep them from
re-closing after angioplasty.
By their nature, Topol told Reuters Health, these procedures injure artery
walls, and diabetics are especially prone to re-narrowing of the blood vessels
and other complications after the procedure.
He said that all diabetics undergoing angioplasty or stenting should receive
abciximab or another drug in the same class, known as platelet blockers. Only
abciximab, however, has been shown to prolong diabetics' survival; and, Topol
noted, its effects were "dramatic."
