Comparison of two platelet glycoprotein IIb/IIIa inhibitors, eptifibatide and abciximab: outcomes, complications and thrombocytopenia during percutaneous coronary …
M Suleiman, L Gruberg, H Hammerman… - The Journal of …, 2003 - europepmc.org
M Suleiman, L Gruberg, H Hammerman, D Aronson, M Halabi, A Goldberg, E Grenadier…
The Journal of invasive cardiology, 2003•europepmc.orgBackground Platelet glycoprotein IIb/IIIa inhibitors have significantly reduced the incidence
of 30-day ischemic events during percutaneous coronary interventions (PCI). However, each
of the three currently available agents has different pharmacological characteristics, safety,
efficacy and costs. There has not been a direct comparison between eptifibatide and
abciximab in the rates of major adverse cardiac events, major complications and
thrombocytopenia. Methods A total of 642 consecutive patients underwent PCI at our …
of 30-day ischemic events during percutaneous coronary interventions (PCI). However, each
of the three currently available agents has different pharmacological characteristics, safety,
efficacy and costs. There has not been a direct comparison between eptifibatide and
abciximab in the rates of major adverse cardiac events, major complications and
thrombocytopenia. Methods A total of 642 consecutive patients underwent PCI at our …
Background
Platelet glycoprotein IIb/IIIa inhibitors have significantly reduced the incidence of 30-day ischemic events during percutaneous coronary interventions (PCI). However, each of the three currently available agents has different pharmacological characteristics, safety, efficacy and costs. There has not been a direct comparison between eptifibatide and abciximab in the rates of major adverse cardiac events, major complications and thrombocytopenia.
Methods
A total of 642 consecutive patients underwent PCI at our institution between January 2000 and December 2001 and were treated with either eptifibatide (n= 342) or abciximab (n= 300) during the procedure. The selection of the IIb/IIIa inhibitor was arbitrary and left to the discretion of the operator. Complete blood counts were performed by routine protocol on all patients 2 and 4 hours after initiation of the drug. We analyzed the in-hospital clinical outcomes and the incidence of thrombocytopenia in this cohort.
Results
Baseline clinical and angiographic characteristics and concomitant drug treatment were similar between the 2 groups, except for a higher incidence of diabetes in the eptifibatide group. The rates of in-hospital death (1.2% eptifibatide group versus 1.0% abciximab group; p= 0.7), stroke (0% for both groups), target vessel revascularization (1.2% eptifibatide group versus 1.0% abciximab group; p= 0.8) and major bleeding complications (1.7% eptifibatide group versus 0.7% abciximab group; p= 0.2) were similar between the 2 groups. Thrombocytopenia was more frequent in the abciximab-treated patients (6%, versus 0% in the eptifibatide group; p< 0.001), including 5 patients who developed profound thrombocytopenia (< 20,000 cells/mm3).
Conclusion
Both agents, eptifibatide and abciximab, proved to have the same rates of in-hospital major adverse cardiac events, bleeding and vascular complications. Abciximab therapy was associated with a significantly higher incidence of thrombocytopenia within 4 hours of drug initiation, which prompted immediate drug discontinuation, but was not associated with increased risk of bleeding, vascular or other complications.
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