Long-term efficacy of platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention

J. Conor O'Shea, Christopher E. Buller, Warren J. Cantor, A. Bleakley Chandler, Eric A. Cohen, David J. Cohen, Ian C. Gilchrist, Neal S. Kleiman, Marino Labinaz, Mina Madan, Gail E. Hafley, Robert M. Califf, Michael M. Kitt, John Strony, James E. Tcheng

Research output: Contribution to journalArticle

102 Scopus citations

Abstract

Context: In the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial, treatment with eptifibatide, a platelet glycoprotein IIb/IIIa integrin blocker, was found to reduce the ischemic complications of nonurgent coronary stent implantation at 48 hours and 30 days. Objective: To determine whether eptifibatide treatment continues to provide durable, long-term benefit after coronary stent intervention. Design and Setting: The ESPRIT trial was a randomized, double-blind, placebo-controlled, parallel-group, crossover-permitted trial conducted from June 1999 through February 2000 at 92 tertiary care centers in the United States and Canada. Participants: A total of 2064 patients scheduled to undergo nonurgent percutaneous coronary intervention with stent implantation. Intervention: Patients were randomly assigned to receive placebo (n=1024) or eptifibatide (two 180-μg/kg boluses, 10 minutes apart, with a continuous infusion of 2.0 μg/kg per minute; n=1040), started immediately before stent implantation and continued for 18 to 24 hours. Patients also received aspirin, heparin, and a thienopyridine. Main Outcome Measures: Composite rates of death or myocardial infarction (MI) and death, infarction, or target vessel revascularization during the 12 months after enrollment. Results: Complete follow-up data were available for 988 patients given eptifibatide (95.0%) and 976 patients given placebo (95.3%). By 12 months, the composite of death or MI had occurred in 8.0% of eptifibatide-treated patients and in 12.4% of placebo-treated patients (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.48-0.83; P=.001). The composite rate of death, MI, or target vessel revascularization was 17.5% in eptifibatide-treated patients vs 22.1% in placebo-treated patients (HR, 0.76; 95% CI, 0.63-0.93; P=.007). Conclusions: Long-term outcomes of nonurgent coronary stent implantation appear to be improved through blockade of the platelet glycoprotein IIb/IIIa integrin with eptifibatide.

Original languageEnglish (US)
Pages (from-to)618-621
Number of pages4
JournalJournal of the American Medical Association
Volume287
Issue number5
DOIs
StatePublished - Feb 6 2002

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Long-term efficacy of platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention'. Together they form a unique fingerprint.

Cite this