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Long-term results following switch from abciximab to eptifibatide during percutaneous coronary intervention
Michael Koutouzis1, Bo Lagerqvist, Jonas Oldgren
1Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. michail.koutouzis@vgregion.se
Insights
Switching from abciximab to eptifibatide for high-risk percutaneous coronary interventions (PCI) did not negatively impact long-term clinical outcomes. This study found no significant differences in major adverse events between patients receiving abciximab versus eptifibatide during PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Platelet glycoprotein (GP) IIb/IIIa receptor inhibitors are crucial for high-risk percutaneous coronary interventions (PCI).
- Cost reduction strategies are essential in healthcare, prompting investigations into alternative therapeutic agents.
Purpose of the Study:
- To evaluate the long-term clinical outcomes following a planned switch from abciximab to eptifibatide during PCI.
- To determine if this switch impacts major adverse cardiovascular events.
Main Methods:
- A retrospective study comparing 1038 patients undergoing PCI before (Group A) and after (Group B) a switch from abciximab to eptifibatide.
- Patients were followed for 30 months, with the primary endpoint being a composite of death, myocardial infarction, stroke, or revascularization.
- Data were sourced from the Swedish Coronary Angiography and Angioplasty Registry.
Main Results:
- No significant difference was observed in the primary composite endpoint between Group A (29.7%) and Group B (29.3%; P = 0.48).
- Individual secondary endpoints also showed no statistically significant variations between the two groups.
- Outcomes remained comparable across subgroups, including those with ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction/unstable angina, and diabetes.
Conclusions:
- A switch from abciximab to eptifibatide as a GP IIb/IIIa receptor inhibitor in PCI is safe and does not negatively affect long-term clinical outcomes.
- This finding supports the potential for cost-effective therapeutic substitutions in interventional cardiology without compromising patient safety or efficacy.
Background:
The usage of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors improves the outcome during high-risk percutaneous coronary interventions (PCI). The aim of this study was to evaluate the long-term effects after a planned switch from abciximab to eptifibatide during PCI.
Hypothesis:
A switch from the general use of abciximab to eptifibatide as a GP IIb/IIIa in connection with PCI would not have any negative effects on long-term clinical outcomes.
Methods:
To reduce costs, a general switch from abciximab to eptifibatide was instituted in 2004 in 2 university hospitals in Sweden. All patients treated 6 months before and 6 months after the switch were followed for 30 months. During the study period, 1038 patients underwent PCI and received a GP IIb/IIIa receptor inhibitor, 481 (46%) before the switch (Group A) and 557 (54%) after the switch (Group B). The 2 groups had similar baseline characteristics. The primary endpoint was the composite of death, myocardial infarction, stroke, or new coronary revascularization (percutaneous or surgical); secondary endpoints were the individual components of this composite. A separate analysis was performed on patients treated for ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction/unstable angina, and diabetes, respectively. Data were collected from the Swedish Coronary Angiography and Angioplasty Registry.
Results:
There were no differences between the groups in the primary endpoint (29.7% in Group A vs 29.3% in Group B; P = 0.48) or in any of the secondary endpoints.
Conclusions:
A switch from the general usage of abciximab to eptifibatide as a GP IIb/IIIa receptor inhibitor in connection with PCI did not seem to have any negative effects on long-term clinical outcomes.
