Early eptifibatide improves TIMI 3 patency before primary percutaneous coronary intervention for acute ST elevation myocardial infarction: results of the randomized integrilin in acute myocardial infarction (INTAMI) pilot trial
Why the study?
Does early eptifibatide given in the emergency room improve pre-PCI infarct vessel patency in patients with acute STEMI scheduled for primary PCI?
Population
102 patients with acute ST elevation myocardial infarction <12 hours scheduled for primary percutaneous…
Comparison
Early eptifibatide given in the emergency room… vs Optional eptifibatide at the time of PCI.
Design
RCT, Randomly assigned
Follow-up
30 days
Authors
Discussion
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Implication
Early eptifibatide improves pre-PCI patency in STEMI; extends upstream GP IIb/IIIa evidence while leaving clinical outcomes open.
Structured PICO
Does early eptifibatide given in the emergency room improve pre-PCI infarct vessel patency in patients with acute STEMI scheduled for primary PCI?
P
Population
102 patients with acute ST elevation myocardial infarction (STEMI) <12 hours scheduled for primary percutaneous coronary intervention (PCI).
I
Intervention
Early eptifibatide (double bolus) given in the emergency room, with the first bolus administered a mean of 45 minutes before angiography.
C
Comparator
Optional eptifibatide at the time of PCI (late or no eptifibatide).
O
Outcome
Patency of the infarct vessel before PCI (TIMI 3 patency).surrogate
Early administration of eptifibatide in the emergency room significantly improves pre-PCI coronary patency in STEMI patients, though larger trials are needed to confirm clinical outcome benefits.
Limitations
- Small sample size (pilot trial)
- Not powered to test whether the angiographic advantage translates into an improvement in clinical outcomes
Cite This Study
Zeymer et al. (2005) studied this question.