TY - JOUR
T1 - Long-term efficacy of platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention
AU - Conor O'Shea, J.
AU - Buller, Christopher E.
AU - Cantor, Warren J.
AU - Bleakley Chandler, A.
AU - Cohen, Eric A.
AU - Cohen, David J.
AU - Gilchrist, Ian C.
AU - Kleiman, Neal S.
AU - Labinaz, Marino
AU - Madan, Mina
AU - Hafley, Gail E.
AU - Califf, Robert M.
AU - Kitt, Michael M.
AU - Strony, John
AU - Tcheng, James E.
PY - 2002/2/6
Y1 - 2002/2/6
N2 - 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.
AB - 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.
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U2 - 10.1001/jama.287.5.618
DO - 10.1001/jama.287.5.618
M3 - Article
C2 - 11829701
AN - SCOPUS:0037028774
SN - 0098-7484
VL - 287
SP - 618
EP - 621
JO - Journal of the American Medical Association
JF - Journal of the American Medical Association
IS - 5
ER -