Table 2.
Studies with eptifibatide in patients undergoing PCI in STEMI
| Reference | Patients (n) | Prior antiplatelet drugs | Patient population | Study groups/dosage of eptifibatide (bolus + infusion) | Endpoints (P) = Primary endpoint | Endpoint results (eptifibatide versus placebo, P-value) | Bleeding endpoints (TIMI bleeding; eptifibatide versus placebo) |
|---|---|---|---|---|---|---|---|
| INTAMI20 | 102 | ASA | STEMI undergoing PCI | Early eptifibatide 2×180 μg/kg + 2.0 μg/kg/min .12–24 hours Late or no eptifibatide |
TIMI III patency prior to PCI (P) Death at 30 days Reinfarction at 30 days |
34% versus 10.2%, P=0.01 3.8% versus 4.1%, P=0.9 5.7% versus 0.0%, P=0.09 |
Major: 10.6 versus 9.1%, P<0.05 |
| TITAN-TIMI 3421 | 343 | ASA | STEMI undergoing primary PCI | Early eptifibatide 2×180 μg/kg + 2.0 μg/kg/min Late or no eptifibatide |
Pre-PCI TIMI corrected frame count (P) Death at 30 days |
77.5±32.2 versus 84.3±30.7, P=0.049 4.0% versus 2.8%, P=0.76 |
Major: 1.7% versus 3.5%, P=NS Minor: 5.2% vs 4.2%, P=NS |
| ASSIST22 | 400 | ASA, clopidogrel | STEMI undergoing primary PCI | Heparin + eptifibatide 2×180 μg/kg + 2.0 μg/kg/min ~18 hours Heparin alone |
Death, reinfarction, recurrent severe ischemia at 30 days (P) | 6.5% versus 5.5%, P=0.69 | Major: 9.5% versus 5.5%, P=0.14 Minor: 12.9% versus 9.1%, P=0.21 |
| HORIZONS-AMI23 | 3,602 | ASA, clopidogrel | STEMI undergoing PCI | Heparin + planned GP IIb/IIIa inh (eptifibatide 45.6%) Bivalirudin + provisional GP IIb/IIIa inh (eptifibatide 3.2%) |
Net clinical outcome and major bleeding complications (P) | 12.1% versus 9.2%, P=0.005 | Major: 5.0% versus 3.1%, P=0.002 Minor: 4.6% versus 2.8%, P=0.006 |
| EVA-AMI32 | 427 | ASA, clopidogrel | STEMI undergoing PCI | Eptifibatide: 2×180 μg/kg + 2.0 μg/kg/min .24 hours Abciximab: 0.25 mg/kg + 0.125 μg/kg/min |
ST-segment resolution at 60 minutes after PCI (P) Death/MI/TVR at 30 days |
13.1% versus 10.0%, P=0.34 7.5% versus 8.5%, P=0.72 |
Major: 4.0% versus 2.0%, P=0.27 Minor: 12.4% versus 9.0%, P=0.28 |
Abbreviations: STEMI, ST-segment elevation myocardial infarction; TIMI, thrombosis in myocardial infarction; NS, not statistically significant; PCI, percutaneous coronary intervention; ASA, aspirin; inh, inhibitor; MI, myocardial infarction; TVR, target vessel revascularization; GP, glycoprotein.