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A Double-Blinded Randomized Controlled Trial Comparing Eptifibatide Bolus Only Versus Bolus Plus Infusion In Patients

Mehdi Mousavi1, Fatemeh Sehati2, Amirhossein Tayebi2

  • 1Nipawin Hospital, Saskatchewan Health Authority, Niapwin, SK, Canada.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|February 3, 2023
PubMed

Insights

Eptifibatide bolus only during percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is as safe as continuous infusion. This approach reduces costs without increasing bleeding or ischemic complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Current guidelines recommend continuous infusion of eptifibatide with heparin during PCI for STEMI.
  • Emerging evidence suggests bolus-only eptifibatide may be sufficient and cost-effective.
  • Randomized trials are needed to confirm the efficacy and safety of bolus-only eptifibatide.

Purpose of the Study:

  • To compare the safety and efficacy of bolus-only eptifibatide versus continuous infusion in patients undergoing PCI for STEMI.
  • To evaluate vascular, bleeding, and ischemic complications in both treatment groups.

Main Methods:

  • A double-blinded, randomized controlled trial involving 330 patients with STEMI undergoing PCI.
  • Patients received either 75 mg IV eptifibatide infusion or a placebo, following an initial bolus.
  • Primary outcomes included vascular or bleeding complications; secondary outcomes included ischemic complications.

Main Results:

  • No significant differences in major bleeding, hematoma, or ecchymosis between the bolus-only and bolus plus infusion groups.
  • Multivariate analysis showed no significant differences in bleeding events.
  • In-hospital death and ischemic events, including stent thrombosis, were similar between groups.

Conclusions:

  • Eptifibatide bolus only during PCI for STEMI is a safe alternative to continuous infusion.
  • This approach does not increase the risk of bleeding or ischemic complications.
  • Using eptifibatide bolus only can be a cost-saving strategy for STEMI patients undergoing PCI.
Abstract

Keywords:
AnticoagulationGP IIb/IIIa inhibitorsMyocardial infarctionPercutaneous coronary interventionST elevation myocardial infarction

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