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Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial.

Publication ,  Journal Article
Tcheng, JE; Lim, IH; Srinivasan, S; Jozic, J; Gibson, CM; O'Shea, JC; Puma, JA; Simon, DI
Published in: Circ Cardiovasc Interv
February 2009

BACKGROUND: Only limited data describe relationships between stent parameters (length and diameter), adverse events after percutaneous coronary intervention, and effects of platelet glycoprotein IIb/IIIa blockade by stent parameters. METHODS AND RESULTS: In this post hoc analysis of the 1983 patients receiving a stent in the Enhanced Suppression of the Platelet Glycoprotein IIb/IIIa Receptor with Integrilin Therapy randomized percutaneous coronary intervention trial of eptifibatide versus placebo, rates of the major adverse cardiac event (MACE) end point (death, myocardial infarction, urgent target-vessel revascularization, or thrombotic bailout) at 48 hours and 1 year were correlated with stent parameters and then analyzed by randomization to eptifibatide versus placebo. In the placebo group, MACE increased with number of stents implanted, total stent length (by quartiles of <15, 15 to <18, 18 to <30, and >or=30 mm), and total stented vessel area (by quartiles of area <141, 141 to <188, 188 to <292, and >or=292 mm(2)). By stent parameters, MACE at 48 hours was reduced in the eptifibatide group at stent lengths of 18 to <30 mm (odds ratio [OR], 0.55; 95% CI, 0.32 to 0.94; P=0.030) and >or=30 mm (OR, 0.43; 95% CI, 0.25 to 0.75; P=0.003), stent diameters of >2.5 to <3.5 mm (OR, 0.56; 95% CI, 0.39 to 0.82; P=0.002), and with 2 stents implanted (OR, 0.39; 95% CI, 0.22 to 0.69; P=0.001). In the placebo group, near-linear relationships were observed between both increasing stent length and increasing stented vessel area and MACE at 48 hours and 1 year (all, P<0.001); these gradients were flattened in the eptifibatide group (P=0.005 for stent length). CONCLUSIONS: Stent parameters predict MACE after percutaneous coronary intervention. Glycoprotein IIb/IIIa blockade mitigates much of the hazard of increasing procedural complexity.

Duke Scholars

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

February 2009

Volume

2

Issue

1

Start / End Page

43 / 51

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombosis
  • Stents
  • Risk Factors
  • Risk Assessment
  • Prosthesis Design
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Odds Ratio
 

Citation

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MLA
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Tcheng, J. E., Lim, I. H., Srinivasan, S., Jozic, J., Gibson, C. M., O’Shea, J. C., … Simon, D. I. (2009). Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial. Circ Cardiovasc Interv, 2(1), 43–51. https://doi.org/10.1161/CIRCINTERVENTIONS.108.809285
Tcheng, James E., Ing Haan Lim, Shankar Srinivasan, Joseph Jozic, C Michael Gibson, J Conor O’Shea, Joseph A. Puma, and Daniel I. Simon. “Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial.Circ Cardiovasc Interv 2, no. 1 (February 2009): 43–51. https://doi.org/10.1161/CIRCINTERVENTIONS.108.809285.
Tcheng JE, Lim IH, Srinivasan S, Jozic J, Gibson CM, O’Shea JC, et al. Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial. Circ Cardiovasc Interv. 2009 Feb;2(1):43–51.
Tcheng, James E., et al. “Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial.Circ Cardiovasc Interv, vol. 2, no. 1, Feb. 2009, pp. 43–51. Pubmed, doi:10.1161/CIRCINTERVENTIONS.108.809285.
Tcheng JE, Lim IH, Srinivasan S, Jozic J, Gibson CM, O’Shea JC, Puma JA, Simon DI. Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial. Circ Cardiovasc Interv. 2009 Feb;2(1):43–51.

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

February 2009

Volume

2

Issue

1

Start / End Page

43 / 51

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombosis
  • Stents
  • Risk Factors
  • Risk Assessment
  • Prosthesis Design
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Odds Ratio