Platelet glycoprotein IIb/IIIa should be blocked before stenting

Eptifibatide, a platelet glycoprotein IIb/IIIa inhibitor substantially reduces ischemic complications in coronary stent interventions and could become a routine pre-treatment in stent coronary implantation, concludes a study published in 16 December Lancet (Lancet 2000 356:2037).In a prospective study, Dr James Tcheng and colleagues from Duke University Medical Centre in North Carolina recruited 2064 patients who were undergoing coronary stent implantation.

By | December 15, 2000

Eptifibatide, a platelet glycoprotein IIb/IIIa inhibitor substantially reduces ischemic complications in coronary stent interventions and could become a routine pre-treatment in stent coronary implantation, concludes a study published in 16 December Lancet (Lancet 2000 356:2037).

In a prospective study, Dr James Tcheng and colleagues from Duke University Medical Centre in North Carolina recruited 2064 patients who were undergoing coronary stent implantation. Immediately before the procedure, patients were randomly allocated to receive eptifibatide or placebo in addition to aspirin, heparin and a thienopyridine. Researchers found that 10.5% of patients given placebo had complications 48 hours after the intervention compared with 6.6% of patients in the treatment group. Similar differences were recorded at 30 days, suggesting a long-term benefit of the drug.

Enhanced suppression of the platelet IIb/IIIa receptor with compounds like eptifibatide is currently used as a reserved treatment for thrombotic bail-out and urgent coronary revascularisation. These data suggest that patients will benefit more if a similar premedication treatment becomes routine before the procedure, but cost implications still need to be addressed.

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