[Eptifibatide in patients with percutaneous coronary intervention in clinical practice. Results of a prospective registry].
OBJECTIVE
The use of potent platelet inhibitors has been shown to reduce the rate of ischemic complications in patients with percutaneous coronary intervention (PCI) in randomized clinical trials. Eptifibatide is a small-molecule glycoprotein (GP) IIb/IIIa receptor inhibitor. Eptifibatide given with a double bolus of 180 microg/kg 10 min apart followed by an infusion of 2.0 microg/kg/h achieves a high grade of platelet inhibition, which was associated with a highly significant clinical benefit in the randomized ESPRIT Study. The aim of the present prospective registry was to evaluate the efficacy and safety of eptifibatide in clinical practice.


METHODS
A total of 673 patients who received eptifibatide during PCI were prospectively enrolled in the registry between January 2001 and November 2002 in 31 clinical centers.


RESULTS
The intervention was performed for stable angina in 283 patients (42.1%), for unstable angina in 70 patients (10.4%), for non-ST elevation myocardial infarction in 120 patients (17.8%), and for acute ST elevation myocardial infarction in 200 patients (29.7%). Therapy with eptifibatide was predominantly initiated in the catheter laboratory before or during the intervention and maintained for a mean of 20 h. Major bleeding complications, in 50% of the patients at the catheter insertion site, were observed in 1.2% of the patients. A thrombocytopenia < 100,000/microl was not reported. The total mortality rate was < 1%, a myocardial infarction or reinfarction was observed in up to 3%, depending on the clinical indication for PCI.


CONCLUSIONS
These data are comparable to the results reported in randomized clinical trials with eptifibatide and document the safety and efficacy of this small-molecule GP IIb/IIIa inhibitor in clinical practice in a wide range of patients undergoing PCI.
Zeymer
Uwe
U
Medizinische Klinik B, Herzzentrum, Ludwigshafen. Uwe.Zeymer@t-online.de
Zahn
Ralf
R
Siegler
Karl Ernst
KE
Senges
Jochen
J
D000787:Angina Pectoris / Q000453:epidemiology* / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000706:statistics & numerical data*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D000077542:Eptifibatide; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000601:surgery*; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000517:prevention & control*; D010455:Peptides / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D015995:Prevalence; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome
D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide