Keywords :
Acute Coronary Syndrome/drug therapy/mortality/therapy; Aged; Angina Pectoris/therapy; Angioplasty, Balloon, Coronary; Combined Modality Therapy; Coronary Angiography; Coronary Artery Bypass; Drug Administration Schedule; Drug Therapy, Combination; Electrocardiography; Female; Hemorrhage/chemically induced; Humans; Infusions, Intravenous; Kaplan-Meier Estimate; Male; Middle Aged; Myocardial Infarction/epidemiology/therapy; Odds Ratio; Peptides/administration & dosage/adverse effects; Platelet Aggregation Inhibitors/administration & dosage/adverse effects; Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors; Thrombosis/epidemiology/prevention & control; Treatment Failure
Abstract :
[en] BACKGROUND: Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. METHODS: We compared a strategy of early, routine administration of eptifibatide with delayed, provisional administration in 9492 patients who had acute coronary syndromes without ST-segment elevation and who were assigned to an invasive strategy. Patients were randomly assigned to receive either early eptifibatide (two boluses, each containing 180 microg per kilogram of body weight, administered 10 minutes apart, and a standard infusion > or = 12 hours before angiography) or a matching placebo infusion with provisional use of eptifibatide after angiography (delayed eptifibatide). The primary efficacy end point was a composite of death, myocardial infarction, recurrent ischemia requiring urgent revascularization, or the occurrence of a thrombotic complication during percutaneous coronary intervention that required bolus therapy opposite to the initial study-group
Scopus citations®
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