Intracoronary bolus administration of eptifibatide during percutaneous coronary stenting for non ST elevation myocardial infarction and unstable angina.

Published

Journal Article

BACKGROUND: Distal embolization of thrombotic debris may occur during and after percutaneous coronary intervention (PCI) for acute coronary syndromes. This may lead to impaired microvascular perfusion, myocardial infarction and increased morbidity and mortality. In vitro studies suggest that high local concentrations of a glycoprotein IIb/IIIa inhibitor may be effective in disaggregating thrombus and thereby prevent microvascular compromise. We hypothesized that intracoronary (IC) administration of eptifibatide during stent implantation for unstable angina/non ST elevation myocardial infarction (UA/NSTEMI) would be safe and would lead to an acceptable rate of normal myocardial perfusion. METHODS: In 54 patients with UA/NSTEMI, 2 boluses of 180 mcg/kg of eptifibatide each were administered via the IC route during PCI. Data were retrospectively collected and reviewed by an independent core laboratory. RESULTS: No adverse events including arrhythmias occurred during IC administration of eptifibatide. There were no deaths or urgent revascularizations among patients treated with IC eptifibatide. One patient (2.0%) sustained a post-procedure myocardial infarction. One patient sustained a TIMI major bleeding event due to a gastrointestinal bleed. There were no TIMI minor bleeding events. Normal post PCI TIMI Myocardial Perfusion Grade was observed in 54% of patients. CONCLUSION: IC bolus administration of eptifibatide was feasible and safe among patients with UA/NSTEMI. Larger prospective and randomized studies are warranted to further explore the efficacy of this strategy. Intracoronary eptifibatide administration during PCI for UA/NSTEMI is feasible and safe.

Full Text

Duke Authors

Cited Authors

  • Deibele, AJ; Kirtane, AJ; Pinto, DS; Lucca, MJ; Neva, C; Shui, A; Murphy, SA; Tcheng, JE; Gibson, CM

Published Date

  • August 2006

Published In

Volume / Issue

  • 22 / 1

Start / End Page

  • 47 - 50

PubMed ID

  • 16786232

Pubmed Central ID

  • 16786232

International Standard Serial Number (ISSN)

  • 0929-5305

Digital Object Identifier (DOI)

  • 10.1007/s11239-006-7454-8

Language

  • eng

Conference Location

  • Netherlands