Abstract | BACKGROUND: METHODS AND RESULTS: Patients undergoing PCI for an acute coronary syndrome were randomized to either intracoronary or intravenous bolus administration of eptifibatide. The primary end point was the local glycoprotein IIb/IIIa receptor occupancy measured in the coronary sinus. There were no angiographic, electrophysiological, or other adverse findings attributable to intracoronary eptifibatide. Platelet glycoprotein IIb/IIIa receptor occupancy was significantly greater with intracoronary versus intravenous administration: first bolus, 94+/-9% versus 51+/-15% (P<0.001); and second bolus, 99+/-2% versus 91+/-4% (P=0.001), respectively. Microvascular perfusion was significantly improved as measured by the corrected thrombolysis in myocardial infarction frame count ( cTFC) with intracoronary versus intravenous administration: pre-PCI, 36 (median) (25th and 75th percentiles, 16 and 64) versus 31 (25th and 75th percentiles, 23 and 45; P=0.8); and post-PCI, 18 (25th and 75th percentiles, 10 and 22) versus 25 (25th and 75th percentiles, 22 and 35; P=0.007), respectively. The only multivariate predictor associated with a post-PCI cTFC rank score was the first bolus glycoprotein IIb/IIIa receptor occupancy (P<0.001). CONCLUSIONS:
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Authors | Albert J Deibele, Lisa K Jennings, James E Tcheng, Cathy Neva, Angela D Earhart, C Michael Gibson |
Journal | Circulation
(Circulation)
Vol. 121
Issue 6
Pg. 784-91
(Feb 16 2010)
ISSN: 1524-4539 [Electronic] United States |
PMID | 20124127
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Peptides
- Platelet Aggregation Inhibitors
- Platelet Glycoprotein GPIIb-IIIa Complex
- Eptifibatide
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Topics |
- Acute Coronary Syndrome
(metabolism, therapy)
- Aged
- Angioplasty, Balloon, Coronary
- Blood Platelets
(drug effects, metabolism)
- Embolism
(metabolism, prevention & control)
- Eptifibatide
- Female
- Humans
- Injections, Intra-Arterial
- Injections, Intravenous
- Male
- Middle Aged
- Peptides
(administration & dosage, pharmacology, therapeutic use)
- Platelet Aggregation Inhibitors
(administration & dosage, pharmacology, therapeutic use)
- Platelet Glycoprotein GPIIb-IIIa Complex
(antagonists & inhibitors, drug effects, metabolism)
- Prospective Studies
- Treatment Outcome
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