WESTPORT, CT (Reuters Health) – Eptifibatide reduces the incidence of angiographic complications during percutaneous coronary interventions (PCIs), according to a report in the November 1st issue of The American Journal of Cardiology. However, even when angiographic complications occur, eptifibatide use is linked to a reduction in the incidence of CK-MB elevations.
Eptifibatide, produced by San Francisco, California-based COR Therapeutics under the trade name Integrilin, inhibits platelet aggregation by blocking the glycoprotein IIb/IIIa receptor.
In the Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis (IMPACT)-II trial, 4010 patients undergoing PCIs were randomized to receive one of two eptifibatide regimens or placebo during the procedure.
Dr. James C. Blankenship, from the Geisinger Medical Center in Danville, Pennsylvania, and colleagues found that eptifibatide-treated patients were significantly less likely to experience angiographic complications than were placebo-treated patients (p = 0.019).
For patients with angiographic complications, eptifibatide use was tied to a reduction in the incidence of CK-MB elevation in the first 24 hours, the researchers note. Similarly, among patients without complications, fewer abnormal CK-MB levels were noted among eptifibatide-treated patients than among placebo-treated patients.
Two major findings from the current study indicate that eptifibatide should be used at the start of PCIs. "First, eptifibatide helps prevent the occurrence of in-laboratory angiographic complications that may contribute to enzyme elevations and clinical complications," the authors state. "Second, eptifibatide may reduce the incidence of myocardial necrosis even in patients without angiographically evident angiographic complications."
Am J Cardiol 2001;88:969-973.
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