PMID- 17090813
OWN - NLM
STAT- MEDLINE
DCOM- 20070207
LR  - 20181201
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 18
IP  - 11
DP  - 2006 Nov
TI  - Bolus-only platelet glycoprotein IIb-IIIa inhibition during percutaneous coronary 
      intervention.
PG  - 521-6
AB  - BACKGROUND: Platelet glycoprotein IIb-IIIa inhibitors (GPI) are traditionally 
      administered as a bolus followed by an infusion. In the current era of routine 
      stenting, we hypothesized that a bolus-only GPI strategy can be used during 
      percutaneous coronary intervention (PCI) in order to reduce bleeding 
      complications, while preserving the benefits of inhibition of platelet 
      aggregation at the time of device deployment. METHODS: We retrospectively 
      analyzed consecutive patients (n = 1001) who underwent PCI and received an 
      unfractionated heparin (UFH) and bolus-only GPI regimen, from January 2003 to 
      August 2004 in a single institution. All patients received clopidogrel and 
      aspirin prior to PCI. Post-procedure myocardial infarction (MI) was defined using 
      the TIMI definitions, and bleeding complications were defined by the criteria 
      used in REPLACE-2. RESULTS: The most frequently used GPI was eptifibatide 
      (58.3%), followed by abciximab (37.3%) and tirofiban (4.3%). The composite 
      outcome of in-hospital death (0.1%), MI (4.3%), repeat revascularization (0) and 
      major plus minor bleeding (2.6%) was 7%. These rates are lower than those that 
      have been reported in the UFH group with planned GPI, and the bivalirudin with 
      provisional GPI arms of the REPLACE-2 trial. After adjustment for baseline and 
      procedural risk factors, the abciximab bolus-only group had a higher rate of 
      major bleeding compared to the eptifibatide bolus-only group (adjusted odds ratio 
      3.5, 95% confidence intervals 1.047 and 11.698; p < 0.05). CONCLUSION: A 
      bolus-only GPI strategy appears to maintain the anti-ischemic benefits of GPI, 
      with the added benefit of reduced bleeding complications and the potential for 
      reduced cost and shortened length of hospital stay.
FAU - Marmur, Jonathan D
AU  - Marmur JD
AD  - State University of New York, SUNY Downstate Medical Center, Brooklyn, New York, 
      USA. jonathan@marmur.com
FAU - Poludasu, Shyam
AU  - Poludasu S
FAU - Agarwal, Ajay
AU  - Agarwal A
FAU - Vladutiu, Pompeiu
AU  - Vladutiu P
FAU - Feit, Alan
AU  - Feit A
FAU - Lapin, Reuven
AU  - Lapin R
FAU - Cavusoglu, Erdal
AU  - Cavusoglu E
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Immunoglobulin Fab Fragments)
RN  - 0 (Peptides)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - NA8320J834 (Eptifibatide)
RN  - X85G7936GV (Abciximab)
SB  - IM
MH  - Abciximab
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods/mortality
MH  - Antibodies, Monoclonal/*administration & dosage/adverse effects
MH  - Chi-Square Distribution
MH  - Combined Modality Therapy
MH  - Coronary Angiography
MH  - Drug Administration Schedule
MH  - Eptifibatide
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunoglobulin Fab Fragments/*administration & dosage/adverse effects
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - Peptides/*administration & dosage/adverse effects
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Pulse Therapy, Drug
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Statistics, Nonparametric
MH  - Survival Rate
EDAT- 2006/11/09 09:00
MHDA- 2007/02/08 09:00
CRDT- 2006/11/09 09:00
PHST- 2006/11/09 09:00 [pubmed]
PHST- 2007/02/08 09:00 [medline]
PHST- 2006/11/09 09:00 [entrez]
PST - ppublish
SO  - J Invasive Cardiol. 2006 Nov;18(11):521-6.