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Open-label, sequential comparison of eptifibatide with abciximab for patients undergoing percutaneous coronary
Marc J Schweiger1, Hameem U Changezi, Deborah Naglieri-Prescod
1Division of Cardiology, Baystate Medical Center, Springfield, Massachusetts 01199, USA. marc.schweiger@bhs.org
Insights
This study found that abciximab and eptifibatide have similar outcomes for patients undergoing percutaneous coronary intervention (PCI). Both platelet glycoprotein IIb/IIIa antagonists demonstrated comparable in-hospital and 30-day results in this comparative analysis.
Area of Science:
- Cardiology
- Pharmacology
- Interventional Cardiology
Background:
- Platelet glycoprotein IIb/IIIa antagonists are crucial for reducing complications after percutaneous coronary intervention (PCI).
- Limited comparative data exist for different agents within this drug class.
- Understanding comparative efficacy is vital for optimizing patient care in interventional cardiology.
Purpose of the Study:
- To compare in-hospital and 30-day outcomes of abciximab versus eptifibatide.
- To analyze outcomes in two sequential patient cohorts undergoing PCI at a single institution.
- To evaluate the safety and efficacy of these agents in a real-world clinical setting.
Main Methods:
- Sequential cohort study comparing abciximab and eptifibatide use in PCI patients.
- Patients receiving abciximab (Sept 1998-Jan 1999) were compared to those receiving eptifibatide (Jan-Apr 1999).
- Exclusion criteria for eptifibatide included renal insufficiency, with these patients continuing abciximab.
Main Results:
- 319 patients received abciximab, and 301 received eptifibatide, with no significant baseline differences except higher renal insufficiency in the abciximab group.
- Procedural success was high (97%) in both groups, primarily for acute coronary syndromes.
- No significant differences in major adverse cardiac events (MACEs) were observed between the abciximab and eptifibatide groups at hospital discharge or 30 days.
Conclusions:
- Abciximab and eptifibatide demonstrate similar in-hospital and 30-day outcomes in patients undergoing PCI.
- These findings support the comparable efficacy of these agents in this patient population.
- Further research may explore outcomes in specific subgroups, including those with renal insufficiency.
Background:
Platelet glycoprotein IIb/IIIa antagonists reduce complications following percutaneous coronary intervention (PCI). There are limited data comparing different agents.
Objective:
The purpose of this study was to compare in-hospital and 30-day outcomes in 2 sequential cohorts of consecutive patients undergoing PCI at our institution who received abciximab or eptifibatide.
Methods:
The first cohort included patients who received abciximab between September 1, 1998, and January 9, 1999, and the second included patients who were treated with eptifibatide between January 11 and April 27, 1999. Per formulary decision, during the latter period, patients with renal insufficiency continued to be treated with abciximab and were ineligible for therapy with eptifibatide. Major adverse cardiac events (MACEs) were evaluated by one or more of the authors and compared.
Results:
A total of 319 patients were treated with abciximab and 301 with eptifibatide. There were no differences in baseline characteristics between the 2 groups, with the exception of a significantly higher proportion of patients with chronic renal insufficiency in the abciximab-treated group (4% vs 0% with eptifibatide; P = 0.03) The majority of interventions were performed for an acute coronary syndrome. Procedural success was 97% in both groups. Eptifibatide patients were treated for a mean 20.4 (5.2) hours, with 10.1% receiving the drug before the procedure. There were no differences in overall or individual MACEs in hospital or at 30 days.
Conclusion:
Our data suggest similar in-hospital and 30-day outcomes for abciximab- and eptifibatide-treated patients undergoing PCI.