Evaluation of Platelet Count and Function in Patients Administered Tirofiban or Eptifibatide Undergoing Percutaneous Coronary Intervention

Platelets play a pivotal role in the initial defense against insult to the vasculature, and they are critically important in the acute care setting of percutaneous coronary intervention (PCI). In this clinical environment, both platelet count and function are often affected. With the increasing use of adjunct antiplatelet agents, which include the antiglycoprotein IIb/IIIa (GPIIb/IIIa) agents, during PCI procedures it is now recognized that it may be important to monitor these agents to ensure that adverse side effects are minimized or avoided. However, traditional methods for monitoring platelet function are not suitable for acute care patient settings. The authors describe the temporal evaluation of platelet count and function of patients receiving an approved dosing regimen of eptifibatide and the RESTORE dosing regimen of tirofiban who are undergoing PCI using a practical and rapid whole-blood platelet function assay that has been developed for use in near-patient settings. The time to achieve maximal platelet inhibition took longer in those patients treated with tirofiban compared with those treated with eptifibatide. However, the recovery of platelet function was more rapid in the tirofiban group. This study demonstrates the utility of monitoring platelet count and function in PCI patients, the importance of which will be addressed in larger outcome studies.