Eptifibatide Bolus Dose During Elective Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Pharmacology

Background:

• Eptifibatide is a glycoprotein IIb/IIIa antagonist used to prevent cardiac ischemic events during percutaneous coronary intervention (PCI).
• Current administration methods include bolus only or bolus plus infusion, with varying complication and bleeding risks.

Purpose of the Study:

• To compare the outcomes and bleeding rates of single bolus intracoronary eptifibatide versus bolus plus intravenous infusion in patients undergoing elective PCI.

Main Methods:

• A quasi-experimental study comparing elective PCI outcomes in 41 patients receiving single bolus intracoronary eptifibatide versus 19 patients receiving bolus plus intravenous infusion.
• In-hospital and follow-up major adverse cardiac events (MACE) and bleeding rates were evaluated.

Main Results:

• The bolus-only group showed lower in-hospital MACE (19.5% vs. 31.6%) and bleeding (14.6% vs. 21.1%) compared to the bolus plus infusion group.
• Follow-up MACE and bleeding rates were also lower in the bolus-only group (15.4% vs. 17.6% and 2.4% vs. 5.3%, respectively).
• While in-hospital mortality was lower in the bolus-only group (4.9% vs. 15.8%), follow-up mortality was higher (10.3% vs. 0%), with no statistically significant differences observed.

Conclusions:

• No significant differences in bleeding or MACE were found between intracoronary bolus infusion and bolus plus intravenous infusion of eptifibatide.
• Intracoronary bolus infusion of eptifibatide may be a preferable option in elective PCI due to potentially lower doses and reduced post-PCI MACE.