Efficacy and Safety of Abbreviated Eptifibatide Treatment in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Section snippets
Methods
The cohort includes consecutive STEMI patients treated between December 1, 2009, and April 30, 2016, at the Triemli Hospital in Zürich, Switzerland, by a primary PCI strategy within 24 hours of symptom onset. Data were collected by the treating physicians, and checked for completeness, plausibility and consistency by a trained study nurse. Patients resuscitated from out of hospital cardiac arrest as well as patients who did not have Thrombolysis in Myocardial Infarction 3 coronary blood flow at
Results
Of 2,215 consecutive STEMI patients who underwent primary PCI, 147 and 516 patients receiving eptifibatide bolus only or conventional bolus and infusion treatment, respectively, were included in subsequent analyses (Figure 1). Before matching, patients receiving eptifibatide bolus only were older compared with conventionally treated patients (62.4 ± 11.7 vs 59.7 ± 11.6 years, p = 0.013), had worse glomerular filtration rate (97 ± 33 vs 105 ± 40 ml/min/m2, p = 0.027), were treated later in the
Discussion
The results of this matched case-control study suggest that eptifibatide treatment facilitating successful primary PCI of selected contemporary STEMI patients can be safely abbreviated to a bolus only regimen. This strategy was not inferior with regard to myocardial infarct size, and reduced the risk of postprocedural major bleeding complications by more than 50% when compared with the conventional eptifibatide bolus and infusion regimen.
Previous randomized trials have consistently shown that
Author Contributions
Florian Fischer: Investigation, Writing – Review & Editing. Samriddhi Buxy: Formal analysis, Validation, Writing – Review & Editing. David J. Kurz: Conceptualization, Writing – Review & Editing. Franz R. Eberli: Writing – Review & Editing, Funding acquisition. Oliver Senn: Writing – Review & Editing, Supervision. Rainer Zbinden: Conceptualization, Writing – Review & Editing. Ulrike Held: Formal analysis, Validation, Writing – Review & Editing, Supervision. Matthias R. Meyer: Conceptualization,
Declaration of Interests
The authors declare that they have no known competing financial interests or personal relations that could have appeared to influence the work reported in this study.
Acknowledgment
We thank Britta Bottignole for her excellent administrative assistance in data collection.
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This study was supported by an unrestricted research grant from Biosensors International Group. The research grant provider had no role in study design, data collection, data analysis, data interpretation, writing of the report, or in the decision to submit the article for publication.