July 20, 2004Circulation
Association Between Platelet Receptor Occupancy After Eptifibatide (Integrilin) Therapy and Patency, Myocardial Perfusion, and ST-Segment Resolution Among Patients With ST-Segment–Elevation Myocardial Infarction
Key result
Higher platelet glycoprotein IIb/IIIa receptor occupancy after eptifibatide therapy was associated with improved epicardial patency (78.2% vs 63.9% RO; P=0.005) and ST-segment resolution.
Why the study?
Does higher platelet receptor occupancy after eptifibatide therapy improve epicardial patency, myocardial perfusion, and ST-segment resolution in STEMI patients?
Population
Patients with ST-elevation myocardial infarction drawn from the low-dose tenecteplase plus eptifibatide arm…
Design
Cohort, Analyzed at 2 independent core laboratories
Follow-up
60 minutes
Authors
Discussion
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Member takes
Implication
Association may inform occupancy-guided dosing in STEMI; hypothesis-generating and should not yet change practice.
Study Design
Type
Observational (n=70)
Structured PICO
Does higher platelet receptor occupancy after eptifibatide therapy improve epicardial patency, myocardial perfusion, and ST-segment resolution in STEMI patients?
P
Population
70 patients with STEMI receiving low-dose tenecteplase plus eptifibatide, evaluated for the association between platelet receptor occupancy and reperfusion.
E
Exposure
Low-dose tenecteplase plus eptifibatide (glycoprotein IIb/IIIa antagonist)
O
Outcome
Epicardial patency (TIMI flow grade 2/3), myocardial perfusion (TIMI myocardial perfusion grade 2/3), and complete (>=70%) ST-segment resolution at 60 minutessurrogate
Main Result
Absolute Event Rate: 78.2% vs 63.9%
p-value: p=0.005
Higher platelet glycoprotein IIb/IIIa receptor occupancy after eptifibatide and tenecteplase therapy is associated with better angiographic and electrocardiographic reperfusion outcomes in STEMI.
Cite This Study
Gibson et al. (2004) conducted an observational in ST-segment-elevation myocardial infarction (STEMI) (n=70). Higher platelet receptor occupancy (RO) vs. Lower platelet receptor occupancy was evaluated on Patent artery (TIMI flow grade 2/3) (p=0.005). Higher platelet glycoprotein IIb/IIIa receptor occupancy after eptifibatide therapy was associated with improved epicardial patency (78.2% vs 63.9% RO; P=0.005) and ST-segment resolution.