Comparison between the Outcomes of Intracoronary and Intravenous Administration of Eptifibatide during Primary Percutaneous Coronary Intervention in Patients with Acute ST-Elevation Myocardial Infarction

Esfandi, Amir; Fotouhi, Mohammad; Allami, Abbas; Ebrahimi, Morteza

doi:10.5551/jat.30965

Cited by 8 publications

(5 citation statements)

References 47 publications

(59 reference statements)

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“…Esfandi et al studied 49 patients, 24 of whom received an intravenous high dosage bolus plus maintenance and 25 of whom received an intracoronary bolus. Gender, age, and other risk factors such as smoking, diabetes mellitus (DM), and high blood pressure were all non-significant in both groups [24], consistent with our findings.…”

Section: Discussionsupporting

confidence: 90%

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

Iqbal¹,

Iqbal²,

Ali³

et al. 2022

PJMHS

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Background and Aim: Thrombosis within the coronary arteries causes ST-elevation myocardial infarction. STEMI can be vascularized by primary PCI, which is class-I indication and the gold standard. The present study aimed to assess the outcome of pericardial tirofiban administration in patients with ST-level myocardial infarction following primary percutaneous coronary intervention. Patients and Methods: This cross-sectional study was conducted on 228 ST-elevation myocardial infarction (STEMI) patients in the Bahawalpur Heart Center, Bahawalpur for the duration of Six months from March 2022 to September 2022. Patients of both gender having an age range 25 to 65 years with STEMI were enrolled and categorized into two groups based on Tirofiban administration are as follows: Group-I comprised of Tirofiban group and Group-II control (non-tirofiban group). All the patients underwent primary percutaneous coronary intervention (PCI). Major bleeding, MACE, TIMI Grade flow, hematoma, myocardial blush, minor bleeding, and mortality were different variables measured. SPSS version 28 was used for data analysis. Results: The overall mean age was 42.82± 10.26 years. Of the total 228 STEMI patients, there were 166 (72.8%) male and 62 (27.2%) were females. The mean age of group-I (n=114) and group-II (n=114) was 41.74 ± 11.62 years and 43.9± 8.9 years. The age-wise distribution of patients were as follows: 74 (32.5%) in 25-35 years, 70 (30.7%) in 36-45 years, 64 (28.1%) in 46-55 years, and 20 (8.8%) in 56-65 years. The prevalence of hypertension, diabetes, and smoker in Tirofiban and non-tirofiban group was 32 (28.1%) vs. 34 (29.8%), 24 (21.1%) vs. 28 (24.6%), and 31 (27.2%) vs. 33 (28.9%) respectively. A p-value of 0.05 indicated that there was an independent difference in TIMI flow grades between the two groups. Based on clinical outcomes, the incidence of partial reperfusion TIMI flow grade, normal myocardial blush grade, major bleeding, MACE, hematoma, minor bleeding, and mortality was found in 72 (31.6%), 146 (64%), 60 (26.3%), 68 (29.8%), 61 (26.8%), 52 (22.8%), and 8 (3.5%) respectively. Conclusion: The present study found that patients with severe thrombus burden and STEMI who underwent emergency coronary intervention received intracoronary tirofiban treatment that was simple, safe, and effective. A significant difference in TIMI flow and myocardial blush grades was observed when intracoronary Tirofiban was administered to STEMI patients undergoing percutaneous coronary intervention compared with patients who did not receive intracoronary Tirofiban. Keywords: Intracoronary Tirofiban, Percutaneous coronary intervention, ST-elevation myocardial infarction, Outcomes

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Section: Discussionsupporting

confidence: 90%

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

Iqbal¹,

Iqbal²,

Ali³

et al. 2022

PJMHS

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“…E. Amir с соавт. [19] также сравнивали и/к и в/в пути введения эптифибатида у пациентов с ИМпST. Они установили, что и/к путь введения ассоциировался со значимым улучшением степени кровотока по TIMI, степени перфузии по TIMI, корректированной степени кровотока, оцененной по количеству кадров (TIMI frame count).…”

Section: Resultsunclassified

“…Our results were the same as the CICERO trial regarding the incidence of 30-day MACE (10% vs 6%, p=0.46), being higher in the I/V than the I/C group. I/C administration of eptifibatide during PPCI in patients with STEMI vs I/V administration of eptifibatide was evaluated in the study of E. Amir et al [19] and they found that I/C rout was associated with significantly better TIMI flow grade, TIMI perfusion grade, and corrected TIMI frame count and also secondary end points including LV ejection fraction, restoration of ST-segment elevation, and inhospital MACEs.…”

Section: Eptifibatid In Primary Pci эптифибатид при первичном чквmentioning

confidence: 99%

Comparison between Bolus Intracoronary versus Bolus Intravenous Injection Regimens of Eptifibatide during Primary Percutaneous Coronary Intervention in Patients with Anterior ST-Segment Elevation Myocardial Infarction

Nab¹,

Mostafa

Elrabat

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Background.Eptifibatide achieves high local concentration via direct intracoronary (I/V) injection as it promotes clot disaggregation, but it remains unclear if it is of superior benefit than the routine intravenous (I/V) administration. Aim. The current study aimed to examine the safety and efficacy of I/C vs I/V bolus regimen dose of eptifibatide during primary percutaneous coronary intervention (PPCI).Material and methods. Prospective, controlled, randomized study enrolled 100 patients with acute anterior ST-segment elevation myocardial infarction (STEMI) eligible for PPCI equally divided into 2 groups (group A received bolus I/C eptifibatide and group B received it I/V) followed by 12-hour continuous I/V infusion. Features related to of myocardial salvage in the form of TIMI flow grade 3, myocardial blush grade 3, ST segment resolution and left ventricular systolic function were evaluated with short-term follow up for 1 month.Results. Mean age of the study population was 50.95±8.45years, there was statistically insignificant difference between both groups regarding baseline characteristics in age (p=0.062), gender (p=0.488), coronary artery disease risk factors (p>0.05), time from onset of pain to admission (p=0.86) or door to balloon (p=0.12). Group A achieved statistically significant better myocardial blush grade 3 (42% vs 10%, p=0.005), ejection faction 30 days after PPCI (46.11±7.81% vs 40.88±6.26%, p=0.005) but statistically insignificant TIMI flow grade 3 (p=0.29) and ST resolution (p=0.34). Incidence of complications in the hospital and 30 days after discharge was statistically insignificant (p>0.05).Conclusion. Both regimens were safe and effective in STEMI patients undergoing PPCI and regimen of I/C bolus eptifibatide achieved better myocardial blush grade and systolic function.

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“…Furthermore, the appropriate route of administration of GP IIb/IIIa (intracoronary versus intravenous) is still debatable [5, 22–24]. IC eptifibatide was found to achieve better outcomes compared to conventional PCI and aspiration thrombectomy devices during primary PCI in STEMI patients [4].…”

Section: Discussionmentioning

confidence: 99%

Intracoronary Eptifibatide During Primary Percutaneous Coronary Intervention in Early Versus Late Presenters with ST Segment Elevation Myocardial Infarction: A Randomized Trial

et al. 2016

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IntroductionThe role of intracoronary (IC) eptifibatide in primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI) and whether time of patient presentation affects this role are unclear. We sought to evaluate the benefit of IC eptifibatide use during primary PCI in early STEMI presenters compared to late STEMI presenters.MethodsWe included 70 patients who presented with STEMI and were eligible for PPCI. On the basis of symptom-to-door time, patients were classified into two arms: early (<3 h, n = 34) vs late (≥3 h, n = 36) presenters. They were then randomized to local IC eptifibatide infusion vs standard care (control group). The primary end point was post-PCI myocardial blush grade (MBG) in the culprit vessel. Other end points included corrected TIMI frame count (cTFC), ST segment resolution (STR) ≥70%, and peak CKMB.ResultsIn the early presenters arm, no difference was observed in MBG results ≥2 in the IC eptifibatide and control groups (100% vs 82%; p = 0.23). In the late presenters arm, the eptifibatide subgroup was associated with improved MBG ≥2 (100% vs 50%; p = 0.001). IC eptifibatide in both early and late presenters was associated with less cTFC (early presenters 19 vs. 25.6, p = 0.001; late presenters 20 vs. 31.5, p < 0.001) and less peak CKMB (early presenters 210 vs 260 IU/L, p = 0.006; late presenters 228 vs 318 IU/L, p = 0.005) compared with the control group. No difference existed between both groups in STR index in early and late presenters.ConclusionIC eptifibatide might improve the reperfusion markers during PPCI for STEMI patients presenting after 3 h from onset of symptoms. A large randomized study is recommended to ascertain the benefits of IC eptifibatide in late presenters on clinical outcomes.

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Comparison between the Outcomes of Intracoronary and Intravenous Administration of Eptifibatide during Primary Percutaneous Coronary Intervention in Patients with Acute ST-Elevation Myocardial Infarction

Abstract: Aim: To compare the outcomes of intracoronary (IC) and intravenous (IV) administration of eptifibatide during primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction (STEMI). Methods

Cited by 8 publications

References 47 publications

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

Comparison between Bolus Intracoronary versus Bolus Intravenous Injection Regimens of Eptifibatide during Primary Percutaneous Coronary Intervention in Patients with Anterior ST-Segment Elevation Myocardial Infarction

Intracoronary Eptifibatide During Primary Percutaneous Coronary Intervention in Early Versus Late Presenters with ST Segment Elevation Myocardial Infarction: A Randomized Trial

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