Question
In people with diabetes and ST-segment elevation myocardial infarction, is half-dose reteplase plus abciximab more effective than reteplase alone?
Study design
Secondary analysis of multicentre randomised controlled trial.
Main results
For mortality at 30 days or 1 year, there was no significant difference between groups (see Table 1). Reteplase plus abciximab significantly reduced the risk of reinfarction, or recurrent ischaemia or angina compared with reteplase alone.Table 1 Clinical outcomes for people with diabetes and ST-segment myocardial infarction. Reteplase alone (n=1299) Half-dose reteplase plus abciximab (n=1334) P value Death within 30 days 8.8% 8.2% 0.57 Death within 1 year 13.0% 12.4% 0.64 Reinfarction 4.3% 2.5% 0.01 Recurrent ischaemia/angina 14.9% 11.8% 0.01
Authors’ conclusions
Although treatment with reteplase plus abciximab did not provide a survival benefit for people with diabetes and ST-segment elevation myocardial infarction compared with reteplase alone, nonfatal outcomes including reinfarction and recurrent ischaemia were substantially reduced.