title: Clinical outcomes comparing eptifibatide and abciximab in ST elevation acute myocardial infarction patients undergoing percutaneous coronary interventions.
abstract: BACKGROUND
  Randomized clinical trials comparing glycoprotein IIb-IIIa inhibitors have largely excluded patients with ST segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  We conducted an open-label, sequential comparison of in-hospital and 6-month clinical outcomes in STEMI patients receiving eptifibatide or abciximab as adjunctive therapy during percutaneous coronary intervention (PCI). Registry data were collected and compared for STEMI patients undergoing PCI and receiving eptifibatide or abciximab over a 3.5-year period. Six-month follow-up, using telephone interviews, included major adverse cardiac events and functional status.
  
  
  RESULTS
  Baseline characteristics were similar for patients receiving eptifibatide (n = 294) or abciximab (n = 158). No significant differences in hospital clinical outcomes were observed for reinfarction (2 vs. 3% for eptifibatide and abciximab, respectively), repeat revascularization (3 vs. 4%), bleeding complications (8 vs. 12%), congestive heart failure (5 vs. 3%), cerebrovascular accidents (0 vs. 2%), renal failure (2 vs. 3%), and all-cause mortality at discharge (5 vs. 4%). No significant difference was seen between groups in all-cause mortality at 6 months (6.5 vs. 6.4%; hazard ratio 0.976; 95% confidence interval 0.43-2.23; log-rank, p = 0.95).
  
  
  CONCLUSIONS
  No significant differences were observed in clinical outcomes between STEMI patients receiving eptifibatide or abciximab in the setting of PCI. Considering the substantially lower cost of eptifibatide, these data suggest that eptifibatide can be substituted for abciximab to lower overall medication costs while maintaining beneficial safety and efficacy effects.
authors.affiliation: Midatlantic Cardiovascular Associates, Baltimore, MD 21204, USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Midei
authors.forename: Vicki J
authors.initials: VJ
authors.lastname: Coombs
authors.forename: David R
authors.initials: DR
authors.lastname: Lowry
authors.forename: Michael N
authors.initials: MN
authors.lastname: Drossner
authors.forename: Kerry C
authors.initials: KC
authors.lastname: Prewitt
authors.forename: John C
authors.initials: JC
authors.lastname: Wang
authors.forename: Michele B
authors.initials: MB
authors.lastname: Loughrey
authors.forename: Sidney O
authors.initials: SO
authors.lastname: Gottlieb
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D000077542:Eptifibatide; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000628:therapy*; D010455:Peptides / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide; D000077284:Abciximab