Key result
Intracoronary eptifibatide bolus only and bolus with intravenous infusion were both associated with good angiographic outcomes, few bleeding events, and low in-hospital MACE.
Why the study?
Does an intracoronary eptifibatide bolus only provide similar safety and efficacy compared to a bolus followed by intravenous infusion in patients undergoing primary PCI for STEMI?
Cohort (n=155)
Does an intracoronary eptifibatide bolus only provide similar safety and efficacy compared to a bolus followed by intravenous infusion in patients undergoing primary PCI for STEMI?
An intracoronary eptifibatide bolus alone may offer comparable safety and efficacy to a bolus plus 18-hour intravenous infusion during primary PCI for STEMI, warranting further investigation in randomized trials.
May support bolus-only intracoronary eptifibatide in STEMI primary PCI; leaves open equivalence without randomized confirmation.
Intracoronary bolus of eptifibatide during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has been shown to result in higher local platelet glycoprotein IIb/IIIa receptor occupancy with improved microvascular perfusion. It is unclear whether intracoronary administration of eptifibatide in a larger patient population results in favourable clinical outcomes. We evaluated the safety and efficacy of two regimens of intracoronary eptifibatide (bolus only versus bolus followed by intravenous infusion) in patients undergoing primary PCI for ST-elevation MI. They were divided into two groups: Group A (n=67) who received fixed-dose intracoronary eptifibatide bolus only and Group B (n=88) who received intracoronary bolus and continuous intravenous infusion of eptifibatide for 18 h. The preliminary findings from our registry showed that both regimens were associated with good angiographic outcomes, few bleeding events and low in-hospital major adverse cardiac events. A large prospective randomized, multi-centre trial is needed to confirm our observation.
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Soon et al. (2012) conducted a cohort in ST-elevation myocardial infarction (n=155). Intracoronary eptifibatide bolus only vs. Intracoronary bolus and continuous intravenous infusion of eptifibatide for 18 h was evaluated on Angiographic outcomes, bleeding events, and in-hospital major adverse cardiac events. Intracoronary eptifibatide bolus only and bolus with intravenous infusion were both associated with good angiographic outcomes, few bleeding events, and low in-hospital MACE.
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