title: Long-term results following switch from abciximab to eptifibatide during percutaneous coronary intervention.
abstract: BACKGROUND
  The usage of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors improves the outcome during high-risk percutaneous coronary interventions (PCI). The aim of this study was to evaluate the long-term effects after a planned switch from abciximab to eptifibatide during PCI.
  
  
  OBJECTIVE
  A switch from the general use of abciximab to eptifibatide as a GP IIb/IIIa in connection with PCI would not have any negative effects on long-term clinical outcomes.
  
  
  METHODS
  To reduce costs, a general switch from abciximab to eptifibatide was instituted in 2004 in 2 university hospitals in Sweden. All patients treated 6 months before and 6 months after the switch were followed for 30 months. During the study period, 1038 patients underwent PCI and received a GP IIb/IIIa receptor inhibitor, 481 (46%) before the switch (Group A) and 557 (54%) after the switch (Group B). The 2 groups had similar baseline characteristics. The primary endpoint was the composite of death, myocardial infarction, stroke, or new coronary revascularization (percutaneous or surgical); secondary endpoints were the individual components of this composite. A separate analysis was performed on patients treated for ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction/unstable angina, and diabetes, respectively. Data were collected from the Swedish Coronary Angiography and Angioplasty Registry.
  
  
  RESULTS
  There were no differences between the groups in the primary endpoint (29.7% in Group A vs 29.3% in Group B; P = 0.48) or in any of the secondary endpoints.
  
  
  CONCLUSIONS
  A switch from the general usage of abciximab to eptifibatide as a GP IIb/IIIa receptor inhibitor in connection with PCI did not seem to have any negative effects on long-term clinical outcomes.
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. michail.koutouzis@vgregion.se
authors.forename: Michael
authors.initials: M
authors.lastname: Koutouzis
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
authors.forename: Jonas
authors.initials: J
authors.lastname: Oldgren
authors.forename: Axel
authors.initials: A
authors.lastname: Akerblom
authors.forename: Magnus
authors.initials: M
authors.lastname: Wahlin
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.forename: Per
authors.initials: P
authors.lastname: Albertsson
authors.forename: Göran
authors.initials: G
authors.lastname: Matejka
authors.forename: Lars
authors.initials: L
authors.lastname: Grip
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000191:economics; D016009:Chi-Square Distribution; D017046:Cost Savings; D016527:Drug Costs; D057915:Drug Substitution; D000077542:Eptifibatide; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage* / Q000191:economics; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010455:Peptides / Q000008:administration & dosage* / Q000191:economics; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000191:economics; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide; D000077284:Abciximab