Six-month outcomes of percutaneous coronary balloon angioplasty in acute coronary syndromes: Results from the PURSUIT trial

Marino Labinaz, Paul Kaul, Robert A. Harrington, Wei Ching Chang, Neal Kleiman, Maarten L. Simoons, Eric Boersma, K. Martijn Akkerhuis, Robert M. Califf, Paul W. Armstrong

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Potent inhibition of the platelet glycoprotein IIb/IIIa receptor has improved the acute outcome of patients presenting with acute coronary syndromes (ACS). For patients with ACS undergoing percutaneous balloon angioplasty without coronary stenting in the era of platelet glycoprotein IIb/IIIa blockade, the long-term prognosis is less clear. Objective: To examine the six-month outcome of patients who received eptifibatide within a randomized clinical trial and subsequently underwent balloon angioplasty. Methods: Patients included in this substudy were enrolled in the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, a randomized study evaluating the efficacy of eptifibatide in reducing the incidence of death or nonfatal myocardial infarction (MI) in non-ST segment elevation ACS. During the index hospitalization, 1151 (12.2%) of the PURSUIT patients underwent percutaneous balloon angioplasty without coronary stenting. Results: Eptifibatide was associated with a significant reduction in the adjudicated composite end point of death or MI at six months after randomization in patients undergoing percutaneous transluminal coronary angioplasty (PTCA) (P=0.037). A trend toward a beneficial effect was evident before the procedure (4.7% versus 6.9%; P=0.13) and at 30 days (12.1% versus 15.3%; P=0.12). The incidence of repeat revascularization was relatively low for patients undergoing PTCA, with no difference Observed between the eptifibatide and placebo groups (16.3%) versus 14.8%; P=0.51). Conclusions: Eptifibatide was associated with a sustained beneficial effect to six months in patients with ACS undergoing PTCA. It reduced the incidence of preprocedural MI. The rate of repeat revascularization at six months was low and was not significantly altered by eptifibatide.

Original languageEnglish (US)
Pages (from-to)773-778
Number of pages6
JournalCanadian Journal of Cardiology
Volume20
Issue number8
StatePublished - Jun 1 2004

Keywords

  • Angioplasty
  • Glycoprotein IIb/IIIa
  • Stents
  • Unstable angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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