title: A randomized, placebo-controlled trial of early eptifibatide for non-ST-segment elevation acute coronary syndromes.
abstract: BACKGROUND
  The acute benefits of platelet glycoprotein IIb/IIIa inhibitors for non-ST-segment elevation acute coronary syndromes (NSTE ACS) remain unclear.
  
  
  METHODS
  In this pilot trial, 311 patients with NSTE ACS were randomly assigned in the emergency department to double-blinded therapy with eptifibatide or placebo for 12 to 24 hours before crossover to open-label eptifibatide. Serial creatine-kinase MB (CK-MB) and quantitative cardiac troponin T levels were collected during the first 24 hours to assess the impact of early platelet glycoprotein IIb/IIIa blockade on infarct size as measured by cardiac markers.
  
  
  RESULTS
  Median peak CK-MB (10.3 vs 11.8 ng/mL; P =.71) and peak quantitative cardiac troponin T levels (0.2 vs 0.3 ng/mL; P =.95) were similar between treatment groups, respectively. Median calculated peak CK-MB values (41 vs 40 ng/mL; P =.72) and area under the CK-MB curve measurements (980 vs 764 microg/min/L; P =.68) from curve-fitting analyses that could be performed in 106 of 311 patients were also similar.
  
  
  CONCLUSIONS
  In this pilot trial, early administration of eptifibatide in the emergency department did not modulate serologic measurements of infarct size in patients with NSTE ACS.
authors.affiliation: Duke Clinical Research Institute, Durham, NC 27715, USA. roe00001@mc.duke.edu
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Roe
authors.forename: Robert H
authors.initials: RH
authors.lastname: Christenson
authors.forename: E Magnus
authors.initials: EM
authors.lastname: Ohman
authors.forename: Raymond
authors.initials: R
authors.lastname: Bahr
authors.forename: Francis M
authors.initials: FM
authors.lastname: Fesmire
authors.forename: Alan
authors.initials: A
authors.lastname: Storrow
authors.forename: Michael
authors.initials: M
authors.lastname: Mollod
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Rosenblatt
authors.forename: Hongqiu
authors.initials: H
authors.lastname: Yang
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Fraulo
authors.forename: James W
authors.initials: JW
authors.lastname: Hoekstra
authors.forename: W Brian
authors.initials: WB
authors.lastname: Gibler
mesh_terms: D000368:Aged; D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D003328:Coronary Thrombosis / Q000188:drug therapy*; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004562:Electrocardiography; D000077542:Eptifibatide; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology / Q000517:prevention & control; D010455:Peptides / Q000627:therapeutic use*; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D013577:Syndrome; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D020107:Troponin T; D003404:Creatinine; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D000077542:Eptifibatide