Abstract 3070: Medium-Term Outcome of IntraCoronary Stand-Alone Bolus Administration of Eptifibatide During Coronary Intervention
Objectives. To evaluate the intermediate results of intracoronary (IC) eptifibatide administration during percutaneous coronary intervention (PCI).
Background: Several studies tested intravenous (IV) bolus and continuous administration of eptifibatide during PCI. There is no present data available considering giving eptifibatide during PCI as IC bolus alone.
Methods: Clinical outcomes of 376 patients who received stents + eptifibatide by 3 different routes during PCI and were followed up for over 24 months. Group A (119 patients) had IC eptifibatide bolus only; group B (119 patients) had IC bolus and continuous IV infusion and group C (138 patients) had IV bolus and continuous IV infusion. The standard systemic bolus doses of eptifibatide 180 micg /kg was given either via IC or IV route and only groups B and C received continuous IV infusion at 2 micg /kg/min for 18–24 hours.
Results: Patients, procedural characteristics and outcomes are shown (Table⇓). The 6, 12, 24-month cumulative TVR was lower in group A (6.7, 11.7, 12.5%) compared to group B (9.2, 14.2, 15 %) and group C (17.4, 30.4, 34 %) P = 0.018 as well as the composite endpoint of death or MI (2.5, 5.8, 9.4) P = 0.015. The frequency of major, minor bleeding and rehospitalization was significantly lower in-group A (2.4, 5.8, 10.9%) compared to group B (7.5, 11.7, 16.8%) and group C (9.5, 17, 28%) P < 0.005.
Conclusion: The IC bolus alone route of eptifibatide may be safer and superior to the IV route and continuous infusion may not be necessary. Large-scale prospective randomized trials are needed to validate these findings.