Eptifibatide vs abciximab as adjunctive therapy during primary percutaneous coronary intervention for acute myocardial infarction

Ganesh Raveendran, Henry H. Ting, Patricia Best, David Holmes, Ryan J. Lennon, Mandeep Singh, Malcolm R. Bell, Kirsten Hall Long, Charanjit Rihal

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: To compare outcomes among patients receiving eptifibatide or abciximab during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) with ST elevation or new left bundle branch block. PATIENTS AND METHODS: From January 1999 through January 2004, 576 patients underwent primary PCI and received adjunctive glycoprotein IIb/IIIa receptor antagonists. Propensity scores were used to adjust for baseline differences between groups. Logistic regression and Cox proportional hazards were used to model the association between choice of glycoprotein IIb/IIIa receptor antagonist and adverse events. RESULTS: Abciximab was given to 327 patients (57%) and eptifibatide to 249 (43%). Observed rates of in-hospital death or MI did not differ between groups (eptifibatide, 6%; abciximab, 5%; P=.95). This result persisted with adjustment for various patient characteristics (adjusted odds ratio, 1.03; 95% confidence interval, 0.40-2.65; P=.95). Kaplan-Meler estimated rates of death, MI, or target vessel revascularization at 1-year follow-up were 20.9% with eptifibatide and 22.3% with abciximab. The adjusted hazard ratio for the composite end point during a median follow-up of 12 months was 1.36 (95% confidence interval, 0.89-2.07; P=.16). CONCLUSION: In this observational analysis, outcomes were similar with use of either abciximab or eptifibatide among patients undergoing primary PCI for acute MI. Additional comparative research is warranted to confirm these results.

Original languageEnglish (US)
Pages (from-to)196-202
Number of pages7
JournalMayo Clinic Proceedings
Volume82
Issue number2
DOIs
StatePublished - 2007

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Percutaneous Coronary Intervention
Myocardial Infarction
Platelet Glycoprotein GPIIb-IIIa Complex
Confidence Intervals
Therapeutics
Propensity Score
Bundle-Branch Block
Logistic Models
Odds Ratio
abciximab
eptifibatide
Mortality
Research

ASJC Scopus subject areas

  • Medicine(all)

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Eptifibatide vs abciximab as adjunctive therapy during primary percutaneous coronary intervention for acute myocardial infarction. / Raveendran, Ganesh; Ting, Henry H.; Best, Patricia; Holmes, David; Lennon, Ryan J.; Singh, Mandeep; Bell, Malcolm R.; Long, Kirsten Hall; Rihal, Charanjit.

In: Mayo Clinic Proceedings, Vol. 82, No. 2, 2007, p. 196-202.

Research output: Contribution to journalArticle

Raveendran, Ganesh ; Ting, Henry H. ; Best, Patricia ; Holmes, David ; Lennon, Ryan J. ; Singh, Mandeep ; Bell, Malcolm R. ; Long, Kirsten Hall ; Rihal, Charanjit. / Eptifibatide vs abciximab as adjunctive therapy during primary percutaneous coronary intervention for acute myocardial infarction. In: Mayo Clinic Proceedings. 2007 ; Vol. 82, No. 2. pp. 196-202.
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AB - OBJECTIVE: To compare outcomes among patients receiving eptifibatide or abciximab during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) with ST elevation or new left bundle branch block. PATIENTS AND METHODS: From January 1999 through January 2004, 576 patients underwent primary PCI and received adjunctive glycoprotein IIb/IIIa receptor antagonists. Propensity scores were used to adjust for baseline differences between groups. Logistic regression and Cox proportional hazards were used to model the association between choice of glycoprotein IIb/IIIa receptor antagonist and adverse events. RESULTS: Abciximab was given to 327 patients (57%) and eptifibatide to 249 (43%). Observed rates of in-hospital death or MI did not differ between groups (eptifibatide, 6%; abciximab, 5%; P=.95). This result persisted with adjustment for various patient characteristics (adjusted odds ratio, 1.03; 95% confidence interval, 0.40-2.65; P=.95). Kaplan-Meler estimated rates of death, MI, or target vessel revascularization at 1-year follow-up were 20.9% with eptifibatide and 22.3% with abciximab. The adjusted hazard ratio for the composite end point during a median follow-up of 12 months was 1.36 (95% confidence interval, 0.89-2.07; P=.16). CONCLUSION: In this observational analysis, outcomes were similar with use of either abciximab or eptifibatide among patients undergoing primary PCI for acute MI. Additional comparative research is warranted to confirm these results.

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