Superior in-hospital and 30-day outcomes with abciximab versus eptifibatide: a contemporary analysis of 495 consecutive percutaneous coronary interventions.
BACKGROUND
Both abciximab (AB) and eptifibatide (EP) are approved for use during percutaneous coronary intervention (PCI) but comparative data between the 2 agents are limited.


METHODS
We compared in-hospital and 30-day outcomes of contemporary 495 consecutive PCIs performed by a single operator between July 2001 and November 02 with AB and EP (242 with AB and 253 with EP). Cardiogenic shock patients who underwent a second procedure within 30 days from their first procedure were excluded. Selection of glycoprotein IIb/IIIa was at the operator's discretion. The initial 444 cases were performed with unfractionated heparin and the last 51 with bivalirudin.


RESULTS
AB cases comprised a higher risk group with more patients with diabetes, peripheral vascular disease, ST-elevation myocardial infarction and renal failure (p<0.05 for each) and more rotablator use and longer lesions (p<0.01 for each). AB was associated with less in-hospital (4.6 versus 12.3%; OR: 0.34; 95% CI: 0.17-0.7; p=0.004) as well as 30-day (5.5 versus 14%; OR: 0.37; 95% CI: 0.19-0.71; p=0.003) major adverse cardiac events (sum of death, MI, urgent revascularization, all bleeding and stroke).


CONCLUSIONS
Despite its use in higher risk PCI patients, AB resulted in superior short-term outcomes compared with EP. Our data suggest that significant efficacy differences may exist between these 2 agents and that a randomized comparison is warranted.
Deliargyris
Efthymios N
EN
Cardiology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA.
Upadhya
Bharathi
B
Applegate
Robert J
RJ
Kutcher
Michael A
MA
Gandhi
Sanjay K
SK
Sane
David C
DC
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D000077542:Eptifibatide; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007431:Intraoperative Complications / Q000517:prevention & control; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D010455:Peptides / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide; D000077284:Abciximab