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Clinical characteristics predict benefits from eptifibatide therapy during coronary stenting: insights from the Enhanced Suppression of the Platelet IIb/IIIa Receptor With Integrilin Therapy (ESPRIT) trial.

Publication ,  Journal Article
Puma, JA; Banko, LT; Pieper, KS; Sacchi, TJ; O'Shea, JC; Dery, JP; Tcheng, JE
Published in: J Am Coll Cardiol
February 21, 2006

OBJECTIVES: In order to determine a differential benefit from treatment, we compared the long-term outcome of high-risk versus low-risk patients and evaluated survival free from death or myocardial infarction at one year. BACKGROUND: Newer anticoagulant strategies during percutaneous coronary intervention have necessitated a reanalysis of the role of intravenous GP IIb/IIIa inhibitors. The Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy trial randomized 2,064 patients undergoing nonurgent coronary stent implantation to eptifibatide or placebo. METHODS: High-risk characteristics were defined as age >75 years, diabetes, elevated cardiac markers, ST-segment elevation myocardial infarction within 7 days, or unstable angina within 48 h of randomization. Age <5 years, absence of diabetes, and any other reason for admission were considered low risk characterstics. RESULTS: There were 1,018 patients in the high-risk group (50.8% eptifibatide, 49.2% placebo) and 1,045 patients in the low-risk group (50.0% eptifibatide, 50.0% placebo). Baseline demographics were similar in both groups except for more hypertension (63% vs. 55%, respectively), peripheral vascular disease (8.2% vs. 5.2%, respectively), prior stroke (5.5% vs. 3.2%, respectively), and female gender (33% vs. 22%, respectively) in the high-risk than the low-risk group. At one year, the composite end point of death or myocardial infarction occurred in 15.89% of placebo patients and 7.99% of eptifibatide patients in the high-risk group and 9.02% of the placebo and 8.11% of eptifibatide patients in the low-risk group. CONCLUSIONS: Although eptifibatide treatment improved outcomes for all patients, preprocedural clinical characteristics can define a subgroup of patients who may derive greatest benefit from its use during coronary stent placement.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

February 21, 2006

Volume

47

Issue

4

Start / End Page

715 / 718

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Stents
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Infarction
  • Middle Aged
 

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Puma, J. A., Banko, L. T., Pieper, K. S., Sacchi, T. J., O’Shea, J. C., Dery, J. P., & Tcheng, J. E. (2006). Clinical characteristics predict benefits from eptifibatide therapy during coronary stenting: insights from the Enhanced Suppression of the Platelet IIb/IIIa Receptor With Integrilin Therapy (ESPRIT) trial. J Am Coll Cardiol, 47(4), 715–718. https://doi.org/10.1016/j.jacc.2005.08.075
Puma, Joseph A., Lesan T. Banko, Karen S. Pieper, Terrence J. Sacchi, J Conor O’Shea, Jean Pierre Dery, and James E. Tcheng. “Clinical characteristics predict benefits from eptifibatide therapy during coronary stenting: insights from the Enhanced Suppression of the Platelet IIb/IIIa Receptor With Integrilin Therapy (ESPRIT) trial.J Am Coll Cardiol 47, no. 4 (February 21, 2006): 715–18. https://doi.org/10.1016/j.jacc.2005.08.075.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

February 21, 2006

Volume

47

Issue

4

Start / End Page

715 / 718

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Stents
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Infarction
  • Middle Aged