Retaplase plus abciximab improves non-fatal outcomes, but not overall survival in people with diabetes and acute ST-segment elevation myocardial infarction

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.