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Similar Early Outcomes With Eptifibatide and Abciximab Before Percutaneous Coronary Intervention: Presented at SCAI

By Crystal Phend

CHICAGO, I.L. -- May 15, 2006 -- The glycoprotein IIb/IIIa inhibitors abciximab and eptifibatide appear to be equally effective in improving in-hospital outcomes when given before a percutaneous coronary intervention (PCI), according to a study presented here at the Society for Cardiovascular Angiography and Interventions annual meeting (SCAI).

Preliminary trials have shown upstream use of abciximab to improve mortality and early restoration of blood flow through a blocked artery. However, "the data on eptifibatide in primary PCI is far more limited than for abciximab," said lead author Rachid Elkoustaf, MD, MPH, senior cardiology fellow, Hartford Hospital, Hartford, Connecticut, in a presentation May 11^th.

The researchers analyzed outcomes for 308 consecutive patients who presented with ST-segment elevation myocardial infarction (MI) and were initially treated with abciximab (176 patients) or eptifibatide (132 patients) and then referred to a tertiary care center to receive PCI.

Risk factors and cardiovascular intervention history were similar between groups as was the severity of disease found on diagnostic catheterization. Patients who received eptifibatide were more likely to receive adjunctive clopidogrel (12% vs. 0.6%) and low molecular weight heparin (8% versus 2%), but were less likely to get thrombolytic agents (61% versus 85%) than those in the abciximab group.

PCI procedure results were not significantly different between the treatment arms. While 55.7% of abciximab-treated patients and 54.2% of eptifibatide-treated patients had complete perfusion (Thrombolysis in Myocardial Infarction 3 flow) initially, that improved to 93.2% and 97.7%, respectively, after the procedure. Stents were placed during 93.2% of procedures in the abciximab group and 88.6% of the eptifibatide group.

Major adverse outcomes reported were all similar between abciximab and eptifibatide groups, including death (3.41% vs. 5.3%), recurrent MI (0% vs. 0.8%), total major adverse cardiovascular events (8% vs. 12.1%), stroke (0.6% vs. 0.08%) and repeat PCI (1.1% vs. 2.3%).

The bleeding risk also appeared to be similar between abciximab and eptifibatide, with minor bleeds occurring in 10.2% and 12.9% and major bleeds 7.4% and 9.8%, respectively.

The researchers concluded that upstream abciximab and eptifibatide result in comparable early outcomes.


[Presentation title: The Impact of Pre-Treatment With Eptifibatide Compared With Abciximab On in-Hospital Outcomes in Patients With ST-Segment Elevation Myocardial Infarction Treated With Facilitated Percutaneous Coronary Intervention. Abstract A-49]

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