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Acute procedural complications and in-hospital events after percutaneous coronary interventions: eptifibatide versus
Andrew E Ajani1, Ron Waksman, Luis Gruberg
1Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
Insights
Eptifibatide and abciximab show comparable safety and efficacy in reducing complications during percutaneous coronary interventions (PCI). Both glycoprotein IIb/IIIa antagonists offer similar outcomes for patients undergoing PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Glycoprotein IIb/IIIa antagonists are crucial for reducing ischemic complications during percutaneous coronary interventions (PCI).
- Prior studies indicate favorable outcomes with both eptifibatide and abciximab in PCI procedures.
- This study aimed to compare the efficacy and safety of eptifibatide versus abciximab in PCI.
Purpose of the Study:
- To compare acute procedural complications and in-hospital events between eptifibatide and abciximab use during PCI.
- To assess potential differences in outcomes for patients receiving these two glycoprotein IIb/IIIa antagonists.
Main Methods:
- Retrospective review of 359 elective PCIs performed between June 1998 and August 2000.
- 152 PCIs were treated with eptifibatide (bolus 180 mcg/kg, infusion 2 mcg/kg/min for 12-48h).
- 205 PCIs were treated with abciximab (bolus 0.25 mg/kg, infusion 10 mcg/min for 12h), with all patients receiving IIb/IIIa antagonists at intervention initiation.
Main Results:
- Patient demographics, angiographic characteristics, indications, and procedural details were similar between groups.
- The maximum activated clotting time (ACT) was lower in the eptifibatide group (235±45 vs. 253±40, P<.0001).
- Eptifibatide and abciximab demonstrated comparable rates of major complications (1.4% vs. 2.9%), repeat PTCA (3.4% vs. 1.9%), and major bleeding (3.3% vs. 4.3%).
Conclusions:
- Eptifibatide is comparable to abciximab in managing acute procedural complications after PCI.
- Both agents exhibit similar rates of in-hospital events, including major complications and bleeding, following percutaneous coronary interventions.
Background:
Glycoprotein IIb/IIIa antagonists reduce peri-angioplasty ischemic complications and improve in-hospital outcome in patients undergoing percutaneous coronary interventions (PCI). Prior studies have demonstrated favorable results with both eptifibatide and abciximab. The purpose of this study was to assess whether there are any differences in rates of acute procedural complications and in-hospital events with the use of these two agents.
Methods:
A retrospective review of 359 elective PCIs from June 1998 to August 2000 identified 152 PCIs treated with eptifibatide (bolus 180 microg/kg, infusion 2 microg/kg/min for 12-48 h) and 205 PCIs treated with abciximab (bolus 0.25 mg/kg, infusion 10 microg/min for 12 h). All patients received IIb/IIIa antagonists at the initiation of the intervention.
Results:
The clinical demographics, the angiographic morphology, the indications, and the procedural details were similar in both groups. In the eptifibatide group, the maximum ACT was lower (235+/-45 vs. 253+/-40, P<.0001). The incidence of major procedural and in-hospital events was compared. Eptifibatide and abciximab had similar rates of major complications (death or myocardial infarction) (1.4% vs. 2.9%), repeat PTCA (3.4% vs. 1.9%), and major bleeding (3.3% vs. 4.3%).
Conclusions:
Eptifibatide is comparable to abciximab in regards to acute procedural complications and in-hospital events after PCI.
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