Ajani Andrew E, Waksman Ron, Gruberg Luis, Sharma Arvind K, Lew Robert, Pinnow Ellen, Canos Daniel A, Cheneau Edouard, Castagna Marco, Satler Lowell, Pichard Augusto, Kent Kenneth M
Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
Cardiovasc Radiat Med. 2003 Jan-Mar;4(1):12-7. doi: 10.1016/s1522-1865(03)00120-3.
Glycoprotein IIb/IIIa antagonists reduce peri-angioplasty ischemic complications and improve in-hospital outcome in patients undergoing percutaneous coronary interventions (PCI). Prior studies have demonstrated favorable results with both eptifibatide and abciximab. The purpose of this study was to assess whether there are any differences in rates of acute procedural complications and in-hospital events with the use of these two agents.
A retrospective review of 359 elective PCIs from June 1998 to August 2000 identified 152 PCIs treated with eptifibatide (bolus 180 microg/kg, infusion 2 microg/kg/min for 12-48 h) and 205 PCIs treated with abciximab (bolus 0.25 mg/kg, infusion 10 microg/min for 12 h). All patients received IIb/IIIa antagonists at the initiation of the intervention.
The clinical demographics, the angiographic morphology, the indications, and the procedural details were similar in both groups. In the eptifibatide group, the maximum ACT was lower (235+/-45 vs. 253+/-40, P<.0001). The incidence of major procedural and in-hospital events was compared. Eptifibatide and abciximab had similar rates of major complications (death or myocardial infarction) (1.4% vs. 2.9%), repeat PTCA (3.4% vs. 1.9%), and major bleeding (3.3% vs. 4.3%).
Eptifibatide is comparable to abciximab in regards to acute procedural complications and in-hospital events after PCI.
糖蛋白IIb/IIIa拮抗剂可减少血管成形术围手术期的缺血并发症，并改善接受经皮冠状动脉介入治疗（PCI）患者的院内结局。既往研究已证实依替巴肽和阿昔单抗均有良好疗效。本研究的目的是评估使用这两种药物时急性手术并发症发生率和院内事件是否存在差异。
对1998年6月至2000年8月期间359例择期PCI进行回顾性分析，确定152例接受依替巴肽治疗的PCI（静脉推注180μg/kg，静脉输注2μg/kg/min，持续12 - 48小时）和205例接受阿昔单抗治疗的PCI（静脉推注0.25mg/kg，静脉输注10μg/min，持续12小时）。所有患者在介入治疗开始时均接受IIb/IIIa拮抗剂治疗。
两组患者的临床人口统计学特征、血管造影形态、适应证和手术细节相似。依替巴肽组的最大活化凝血时间（ACT）较低（235±45 vs. 253±40，P<0.0001）。比较了主要手术和院内事件的发生率。依替巴肽和阿昔单抗的主要并发症（死亡或心肌梗死）发生率相似（1.4% vs. 2.9%），重复PTCA发生率相似（3.4% vs. 1.9%），严重出血发生率相似（3.3% vs. 4.3%）。
在PCI术后的急性手术并发症和院内事件方面，依替巴肽与阿昔单抗相当。
