Three RCTs (n=1,101) were included.
All of the studies were placebo-controlled and one was double-blinded.
Abciximab was associated with a statistically significant reduction in the cumulative hazard rate for death or reinfarction compared with placebo: 12.9% versus 19.0%; (RR 0.633, 95% CI: 0.452, 0.887, p=0.008); no significant study/treatment interaction was found. The NNT to prevent one death or reinfarction was 19 (95% CI: 11, 135).
Abciximab was associated with a reduction in the cumulative hazard rate for death at the limit of statistical significance (10.8% versus 14.3%; RR 0.695, 95% CI: 0.482, 1.003, p=0.052) and a statistically significant reduction in the cumulative hazard rate for reinfarction (2.25% versus 5.5%; RR 0.41. 95% CI: 0.203, 0.831. p=0.013; NNT to prevent one re-infarction was 31, 95% CI: 18, 133).
There was no statistically significant difference between abciximab and placebo in the rate of major bleeding: 14 patients in the abciximab group versus 11 in the placebo group (p>0.5).
In control treatment arms, death or cumulative MI rates and death rates were four times higher among diabetics compared with nondiabetics: 54% versus 13.5% and 39.7% versus 10.1%, respectively.
The subgroup analysis showed that, in diabetics, abciximab was associated with a significant reduction in death or reinfarction compared with placebo (RR 0.525, 95% CI: 0.303, 0.911, p=0.022); the NNT was 6 (95% CI: 4, 64). In hypertensive patients, abciximab was associated with a significant reduction in reinfarction (RR 0.210, 95% CI: 0.06, 0.738, p=0.015) and death or reinfarction (RR 0.562, 95% CI: 0.358, 0.882, p=0.012) compared with placebo.