Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Clin Cardiol. 2010 Nov;33(11):686-92. doi: 10.1002/clc.20814.
The usage of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors improves the outcome during high-risk percutaneous coronary interventions (PCI). The aim of this study was to evaluate the long-term effects after a planned switch from abciximab to eptifibatide during PCI.
A switch from the general use of abciximab to eptifibatide as a GP IIb/IIIa in connection with PCI would not have any negative effects on long-term clinical outcomes.
To reduce costs, a general switch from abciximab to eptifibatide was instituted in 2004 in 2 university hospitals in Sweden. All patients treated 6 months before and 6 months after the switch were followed for 30 months. During the study period, 1038 patients underwent PCI and received a GP IIb/IIIa receptor inhibitor, 481 (46%) before the switch (Group A) and 557 (54%) after the switch (Group B). The 2 groups had similar baseline characteristics. The primary endpoint was the composite of death, myocardial infarction, stroke, or new coronary revascularization (percutaneous or surgical); secondary endpoints were the individual components of this composite. A separate analysis was performed on patients treated for ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction/unstable angina, and diabetes, respectively. Data were collected from the Swedish Coronary Angiography and Angioplasty Registry.
There were no differences between the groups in the primary endpoint (29.7% in Group A vs 29.3% in Group B; P = 0.48) or in any of the secondary endpoints.
A switch from the general usage of abciximab to eptifibatide as a GP IIb/IIIa receptor inhibitor in connection with PCI did not seem to have any negative effects on long-term clinical outcomes.
血小板糖蛋白（GP）IIb/IIIa 受体抑制剂的使用改善了高危经皮冠状动脉介入治疗（PCI）的结果。本研究旨在评估 PCI 期间从阿昔单抗计划切换至依替巴肽后长期的影响。
将阿昔单抗作为 GP IIb/IIIa 在 PCI 中的常规使用切换至依替巴肽不会对长期临床结果产生任何负面影响。
为了降低成本，2004 年瑞典的 2 所大学医院开始将阿昔单抗普遍切换为依替巴肽。所有在切换前后 6 个月接受治疗的患者均随访 30 个月。在研究期间，有 1038 例患者接受了 PCI，并接受了 GP IIb/IIIa 受体抑制剂治疗，其中 481 例（46%）在切换前（A 组），557 例（54%）在切换后（B 组）。两组具有相似的基线特征。主要终点是死亡、心肌梗死、卒中和新的冠状动脉血运重建（经皮或手术）的复合终点；次要终点是该复合终点的各个组成部分。分别对接受 ST 段抬高型心肌梗死、非 ST 段抬高型心肌梗死/不稳定型心绞痛和糖尿病治疗的患者进行了单独分析。数据来自瑞典冠状动脉血管造影和血管成形术登记处。
两组在主要终点（A 组为 29.7%，B 组为 29.3%；P = 0.48）或任何次要终点均无差异。
将阿昔单抗作为 GP IIb/IIIa 受体抑制剂在 PCI 中的常规使用切换至依替巴肽似乎不会对长期临床结果产生任何负面影响。
