The Relative Safety and Efficacy of Abciximab and Eptifibatide in Patients Undergoing Primary Percutaneous Coronary Intervention. Insights From a Large Regional Registry of Contemporary Percutaneous Coronary Intervention

Hitinder S. Gurm, Dean E. Smith, J. Stewart Collins, David Share, Arthur Riba, Andrew J. Carter, Thomas LaLonde, Eva Kline-Rogers, Michael O'Donnell, Hameem Changezi, Marcel Zughaib, Robert Safian, Mauro Moscucci

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Abstract

Objectives: This study sought to assess whether the use of eptifibatide instead of abciximab is associated with a difference in outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background: Pooled data from randomized controlled trials suggest that the use of abciximab may be associated with a survival advantage in patients undergoing primary PCI for acute STEMI. However, a large proportion of patients in the community are treated with eptifibatide, an agent that shares some but not all pharmacological properties with abciximab. Methods: We evaluated the outcomes of 3,541 patients who underwent primary PCI for STEMI from October 2002 to July 2006 in a large regional consortium and who were treated with abciximab (n = 729) or with eptifibatide (n = 2,812). Results: There was no difference in the incidence of in-hospital death (4.1% with abciximab vs. 3.5% with eptifibatide, p = 0.39), recurrent myocardial infarction (0.8% vs. 1.2%, p = 0.42), or stroke/transient ischemic attack (0.7% vs. 0.6%, p = 0.80). There was no difference in the need for blood transfusion (12.4% vs. 11.7%, p = 0.61), whereas there was a greater incidence of gastrointestinal bleeding with abciximab (4.8% vs. 2.8%, p = 0.01). In parsimonious risk-adjusted models, no significant difference between abciximab and eptifibatide was observed with respect to any of the outcomes measures. Conclusions: Currently, eptifibatide is used as the adjunct antiplatelet agent in the majority of patients undergoing primary PCI. There is no apparent difference in early outcomes of patients treated with eptifibatide compared with patients treated with abciximab.

Original languageEnglish
Pages (from-to)529-535
Number of pages7
JournalJournal of the American College of Cardiology
Volume51
Issue number5
DOIs
StatePublished - Feb 5 2008

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Percutaneous Coronary Intervention
Registries
Safety
abciximab
eptifibatide
Platelet Aggregation Inhibitors
Transient Ischemic Attack
Incidence
Blood Transfusion
Randomized Controlled Trials
Stroke
Myocardial Infarction
Outcome Assessment (Health Care)
Pharmacology
Hemorrhage
Survival
ST Elevation Myocardial Infarction

ASJC Scopus subject areas

  • Nursing(all)

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The Relative Safety and Efficacy of Abciximab and Eptifibatide in Patients Undergoing Primary Percutaneous Coronary Intervention. Insights From a Large Regional Registry of Contemporary Percutaneous Coronary Intervention. / Gurm, Hitinder S.; Smith, Dean E.; Collins, J. Stewart; Share, David; Riba, Arthur; Carter, Andrew J.; LaLonde, Thomas; Kline-Rogers, Eva; O'Donnell, Michael; Changezi, Hameem; Zughaib, Marcel; Safian, Robert; Moscucci, Mauro.

In: Journal of the American College of Cardiology, Vol. 51, No. 5, 05.02.2008, p. 529-535.

Research output: Contribution to journalArticle

Gurm, Hitinder S. ; Smith, Dean E. ; Collins, J. Stewart ; Share, David ; Riba, Arthur ; Carter, Andrew J. ; LaLonde, Thomas ; Kline-Rogers, Eva ; O'Donnell, Michael ; Changezi, Hameem ; Zughaib, Marcel ; Safian, Robert ; Moscucci, Mauro. / The Relative Safety and Efficacy of Abciximab and Eptifibatide in Patients Undergoing Primary Percutaneous Coronary Intervention. Insights From a Large Regional Registry of Contemporary Percutaneous Coronary Intervention. In: Journal of the American College of Cardiology. 2008 ; Vol. 51, No. 5. pp. 529-535.
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abstract = "Objectives: This study sought to assess whether the use of eptifibatide instead of abciximab is associated with a difference in outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background: Pooled data from randomized controlled trials suggest that the use of abciximab may be associated with a survival advantage in patients undergoing primary PCI for acute STEMI. However, a large proportion of patients in the community are treated with eptifibatide, an agent that shares some but not all pharmacological properties with abciximab. Methods: We evaluated the outcomes of 3,541 patients who underwent primary PCI for STEMI from October 2002 to July 2006 in a large regional consortium and who were treated with abciximab (n = 729) or with eptifibatide (n = 2,812). Results: There was no difference in the incidence of in-hospital death (4.1{\%} with abciximab vs. 3.5{\%} with eptifibatide, p = 0.39), recurrent myocardial infarction (0.8{\%} vs. 1.2{\%}, p = 0.42), or stroke/transient ischemic attack (0.7{\%} vs. 0.6{\%}, p = 0.80). There was no difference in the need for blood transfusion (12.4{\%} vs. 11.7{\%}, p = 0.61), whereas there was a greater incidence of gastrointestinal bleeding with abciximab (4.8{\%} vs. 2.8{\%}, p = 0.01). In parsimonious risk-adjusted models, no significant difference between abciximab and eptifibatide was observed with respect to any of the outcomes measures. Conclusions: Currently, eptifibatide is used as the adjunct antiplatelet agent in the majority of patients undergoing primary PCI. There is no apparent difference in early outcomes of patients treated with eptifibatide compared with patients treated with abciximab.",
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AU - Smith, Dean E.

AU - Collins, J. Stewart

AU - Share, David

AU - Riba, Arthur

AU - Carter, Andrew J.

AU - LaLonde, Thomas

AU - Kline-Rogers, Eva

AU - O'Donnell, Michael

AU - Changezi, Hameem

AU - Zughaib, Marcel

AU - Safian, Robert

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