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Switch from abciximab to eptifibatide during percutaneous coronary intervention

Magnus Wahlin1, Per Albertsson, Thomas Karlsson

  • 1The Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital and Gothenburg University, Sweden.

International Journal of Cardiology
|July 16, 2008
PubMed

Insights

Switching from abciximab to eptifibatide for glycoprotein IIb/IIIa inhibition during percutaneous coronary intervention (PCI) did not show significant clinical outcome differences up to six months. Further studies are needed to confirm if eptifibatide is a safe alternative to abciximab in PCI.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Pharmacology

Background:

  • Glycoprotein (GP) IIb/IIIa inhibitors are crucial for reducing ischemic complications during percutaneous coronary intervention (PCI).
  • Abciximab is well-documented but more expensive than eptifibatide.
  • This study investigates the clinical outcomes following a switch from abciximab to eptifibatide.

Purpose of the Study:

  • To evaluate the clinical outcomes up to six months after switching from abciximab to eptifibatide for GPIIb/IIIa inhibition during PCI.
  • To compare the safety and efficacy of eptifibatide versus abciximab in a real-world clinical setting.

Main Methods:

  • A cohort study followed 660 patients undergoing de novo PCI.
  • Patients received either abciximab (n=310) or eptifibatide (n=350) for GPIIb/IIIa inhibition.
  • Clinical outcomes were assessed up to six months post-PCI, comparing patients before and after the drug switch.

Main Results:

  • Baseline characteristics were similar between the abciximab and eptifibatide groups.
  • Trends suggested lower in-hospital (0.6% vs 2.0%) and six-month mortality (2.3% vs 3.7%) with abciximab, though not statistically significant (NS).
  • The combined endpoint of death, myocardial infarction, stroke, revascularization, and bleeding occurred in 14.9% (abciximab) vs 16.8% (eptifibatide) (NS).

Conclusions:

  • No significant clinical outcome deterioration was observed after switching from abciximab to eptifibatide for routine GPIIb/IIIa inhibition during PCI.
  • A clinically significant difference between the two agents cannot be excluded due to the limited sample size.
  • Eptifibatide appears to be a viable alternative to abciximab in this patient population.
Abstract

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