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Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators.

Publication ,  Journal Article
Marso, SP; Bhatt, DL; Roe, MT; Houghtaling, PL; Labinaz, M; Kleiman, NS; Dyke, C; Simmoons, ML; Califf, RM; Harrington, RA; Topol, EJ
Published in: Circulation
December 12, 2000

BACKGROUND: Patients with a recent episode of non-ST-segment elevation acute coronary syndrome before CABG have higher rates of operative morbidity and mortality than patients with stable coronary syndromes. The efficacy of administering eptifibatide to these patients undergoing in-hospital CABG is unknown. METHODS AND RESULTS: The Platelet Glycoprotein IIb-IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial randomized 10 948 patients to receive either eptifibatide or placebo. There were 1558 study participants who underwent in-hospital CABG: 692 received placebo, and 866 received eptifibatide. The main substudy analysis end point was death or myocardial infarction (MI) rates at the 6-month follow-up. The 30-day death or MI rates were 30. 8% and 26.1% for the placebo and eptifibatide groups, respectively (P:=0.041). The benefit of eptifibatide administration persisted through 6-months of follow-up (32.7% versus 27.6% for placebo versus eptifibatide, respectively; P:=0.029). There was a greater reduction in the 6-month death or MI rate for patients who received eptifibatide within 72 hours of CABG (33.6% versus 23.8%; P:=0.002) compared with the >72-hour group (31.6% versus 32%; P:=1.0). The incidence of major bleeding was 56.6% for placebo-treated patients versus 58.2% for eptifibatide-treated patients (P:=0.7). CONCLUSIONS: Eptifibatide administration in patients undergoing in-hospital CABG with a recent episode of a non-ST-segment elevation acute coronary syndrome results in a significant reduction in death or MI that is evident at 7 days and persists through the 6-month follow-up without a significant increase in perioperative bleeding rates.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 12, 2000

Volume

102

Issue

24

Start / End Page

2952 / 2958

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

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Marso, S. P., Bhatt, D. L., Roe, M. T., Houghtaling, P. L., Labinaz, M., Kleiman, N. S., … Topol, E. J. (2000). Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators. Circulation, 102(24), 2952–2958. https://doi.org/10.1161/01.cir.102.24.2952
Marso, S. P., D. L. Bhatt, M. T. Roe, P. L. Houghtaling, M. Labinaz, N. S. Kleiman, C. Dyke, et al. “Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators.Circulation 102, no. 24 (December 12, 2000): 2952–58. https://doi.org/10.1161/01.cir.102.24.2952.
Marso SP, Bhatt DL, Roe MT, Houghtaling PL, Labinaz M, Kleiman NS, et al. Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators. Circulation. 2000 Dec 12;102(24):2952–8.
Marso, S. P., et al. “Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators.Circulation, vol. 102, no. 24, Dec. 2000, pp. 2952–58. Pubmed, doi:10.1161/01.cir.102.24.2952.
Marso SP, Bhatt DL, Roe MT, Houghtaling PL, Labinaz M, Kleiman NS, Dyke C, Simmoons ML, Califf RM, Harrington RA, Topol EJ. Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators. Circulation. 2000 Dec 12;102(24):2952–2958.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 12, 2000

Volume

102

Issue

24

Start / End Page

2952 / 2958

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Middle Aged
  • Male
  • Humans
  • Female