Complementary effects of thienopyridine pretreatment and platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention; Results from the ESPRIT trial

Jp, Déry; Campbell, ME; Mathias, Jasmine; Pieper, Karen; Ra, Harrington; Madan, Mina; Gibson, C. Michael; Tr, Tolleson; Jc, O'Shea; Je, Tcheng; Investigators, Esprit

doi:10.1002/ccd.21059

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…Thus, in this population undergoing non-emergency PCI, with an adequate loading dose of clopidogrel (and aspirin), there is sufficient antiplatelet effect without the addition of a third agent. In contrast, a similar analysis of the ESPRIT trial (122) suggested that there was an additive effect by combining the two classes of agents. In this case, the fibrinogen receptor antagonist, epifibatide, was given in a loading dose that may have failed to suppress completely platelet aggregation throughout the procedure, explaining the additive effects of combining the two drugs.…”

Section: Evolution Of the Clinical Use Of Clopidogrelmentioning

confidence: 99%

Historical Lessons in Translational Medicine

Fitzgerald

FitzGerald

2013

Circulation Research

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The development of drugs that inhibit platelets has been driven by a combination of clinical insights, fundamental science and sheer luck. The process has evolved as the days of stumbling upon therapeutic gems like aspirin have long passed and have been replaced by an arduous process where a drug is designed to target a specific protein implicated in a well-characterized pathophysiological process. Or so we would like to believe. The development of antiplatelet therapy illustrates the importance of understanding the mechanisms of disease and the pharmacology of the compounds we develop, coupled with careful clinical experimentation and observation. And yes, still, a fair bit of luck.

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Section: Evolution Of the Clinical Use Of Clopidogrelmentioning

confidence: 99%

Historical Lessons in Translational Medicine

Fitzgerald

FitzGerald

2013

Circulation Research

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“…Also, optimal outcomes were attained by receiving thienopyridine pretreatment along with eptifibatide therapy. [13] In a study conducted between January 2003 and August 2005, the long-term mortality after bolus-only administration of abciximab, eptifibatide, and tirofiban during PCI were evaluated. As is shown in their results, eptifibatide was able to ameliorate long-term survival prognosis compared to abciximab when applied bolus-only.…”

Section: Introductionmentioning

confidence: 99%

Immediate outcomes of eptifibatide therapy during intracoronary stent implantation

et al. 2016

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Background:The objective of the present study was to assess the major immediate outcomes of eptifibatide therapy during intracoronary stent implantation.Materials and Methods:In an interventional study, patients undergoing percutaneous coronary intervention (PCI) were randomized into either the eptifibatide (n = 100) or the control (n = 107) group. In each group, demographic and clinical characteristics such as cardiac death, stent thrombosis (ST), myocardial infarction (MI), rates of target lesion and vessel revascularization, cerebral vascular accident (CVA), and emergency coronary artery bypass grafting (CABG) were recorded.Results:The overall rates of major adverse events such as mortality, Stent thrombosis (ST), Myocardial Infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), CVA, and emergency CABG within 24 h after stent implantation were low and comparable between the two groups; P > 0.05 considered significant for all comparisons.Conclusion:There were no statistical differences between the clinical outcomes of groups administered with single-dose intracoronary eptifibatide and control groups among patients undergoing PCI during stent implantation.

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“…The efficacy benefit was observed among those patients who were troponin positive (13.1% vs 18.3%; P = 0.02; RR, 0.71). Similar benefits of combined GPIIb/IIIa inhibition in conjunction with thienopyridine administration have been observed with eptifibatide [27].…”

Section: Fondaparinuxmentioning

confidence: 56%