title: Effect of a shortened-duration Eptifibatide infusion (75 mg) as adjunctive therapy for percutaneous coronary intervention on in-hospital cardiovascular outcomes and bleeding.
abstract: A retrospective cohort analysis was conducted on patients who underwent percutaneous coronary intervention (PCI) before and after a practice change which reduced the infusion duration of eptifibatide from 18 hours to the time required for completion of a single vial of 75 mg initiated during PCI. Primary end points were inhospital cardiovascular events, target vessel revascularization, and major or minor bleeding. The secondary end point was drug cost. A total of 1,647 patients received the standard-duration infusion (18 hours), and 1,237 received the short-duration infusion. The median infusion times were 18.1 hours (interquartile range 17.7 to 18.7) and 6.6 hours (interquartile range 5.6 to 11.3) in the standard- and short-duration groups, respectively. No differences were found for the rate of inhospital cardiovascular events (2.0% vs 1.9%, respectively; p = 0.78) or inhospital revascularization (0.2% vs 0.3%, respectively; p = 0.68). Also, no statistically significant difference was observed in major bleeding (standard 4.3% vs short 4.4%; p = 0.94) or minor bleeding (standard 3.3% vs short 2.3%; p = 0.09). In conclusion, using a shortened infusion reduced eptifibatide use by an average of 1.6 vials at cost savings of $823 per patient and resulted in no difference in inhospital cardiovascular events, revascularization, or bleeding.
authors.affiliation: Department of Pharmacy Services, Mayo Clinic, Rochester, Minnesota. Electronic address: nei.scott@mayo.edu.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Nei
authors.affiliation: Department of Pharmacy Services, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Armon
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Dierkhising
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Bell
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Verghese
authors.initials: V
authors.lastname: Mathew
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Barsness
authors.affiliation: Department of Pharmacy Services, Mayo Clinic, Rochester, Minnesota.
authors.forename: Narith N
authors.initials: NN
authors.lastname: Ou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000077542:Eptifibatide; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D007260:Infusion Pumps; D007297:Inpatients; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D008910:Minnesota; D009203:Myocardial Infarction / Q000628:therapy; D010455:Peptides / Q000008:administration & dosage* / Q000191:economics; D062645:Percutaneous Coronary Intervention / Q000191:economics; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000191:economics; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide