Table 1.
Review of the Clinical Trials of the Glycoprotein IIb/IIIa Antagonists in the Coronary Circulation
| Agent | Trial | Indication | Dosage Regimen | Overall Outcomes (%) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bolus (μg/kg) | Infusion (dose/min) | Infusion Duration (h) | Death | MI | Urgent Intervention | Major Bleeding* | ||||||
| Abciximab | EPIC | High risk for abrupt closure during PTA | 250 | 10 μg | 12 | 1.7 | 5.2 | 3.2 | 14.0 | |||
| EPILOG | Elective or urgent PTA | 250 | 0.125 μg/kg to a maximum dose of 10 μg | 12 | 0.4 | 3.8 | 2.3 | 3.5 | ||||
| CAPTURE | PTA for UA | 250 | 10 μg | 18–24 | 1.0 | 4.8 | 7.8 | 3.8 | ||||
| EPISTENT | Elective or urgent PTA or stent placement for UA, post-MI, stable angina | 250 | 0.125 μg/kg to a maximum dose of 10 μg | 12 | Post-stent | |||||||
| 0.3 (30 d), 1.0 (1 year), | 4.5 (30 d), 5.9 (1 year) | 1.3 (30 d) | 1.5 | |||||||||
| Post-PCI | ||||||||||||
| 0.8 (30 d), 2.1 (1 year) | 5.3 (30 d), 7.7 (1 year) | 1.9 (30 d) | 1.4 | |||||||||
| Eptifibatide | IMPACT-II | PTA for UA, post MI, stable angina | 135 | 0.5 μg/kg | 20–24 | 0.5 | 6.6 | 4.7 | 5.1 | |||
| 135 | 0.75 μg/kg | 20–24 | 0.8 | 6.9 | 5.4 | 5.2 | ||||||
| ESPIRIT | Elective or urgent stent placement | 180 × 2, every10 minutes | 2 μg/kg | 18–24 | 0.1 (48 h), 0.4 (30 d), 0.8 (6 m) | 5.4 (48 h), 6.2 (30 d), 7.0 (6 m) | 0.6 (48 h), 1.9 (30 d), 8.6 (6 m) | 1.3 | ||||
| Tirofiban | RESTORE | PTA within 72 h of UA or MI | 10 | 0.15 μg/kg | 36 | 0.8 | 4.2 | 7.6 | 5.3 | |||
MI, myocardial infarction; PCI, percutaneous coronary intervention; PTA, percutaneous transluminal angioplasty; UA, unstable angina
*
Major bleeding is defined as intracranial or retroperitoneal hemorrhage, need for surgical intervention, reduction of hemoglobin <5 mg/dL, transfusion greater than 2 U of blood.