Comparison of two platelet glycoprotein IIb/IIIa inhibitors, eptifibatide and abciximab: Outcomes, complications and thrombocytopenia during percutaneous coronary intervention

Mahmoud Suleiman, Luis Gruberg, Haim Hammerman, Doron Aronson, Majdi Halabi, Alexander Goldberg, Ehud Grenadier, Monther Boulus, Walter Markiewicz, Rafael Beyar

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Platelet glycoprotein IIb/IIIa inhibitors have significantly reduced the incidence of 30-day ischemic events during percutaneous coronary interventions (PCI). However, each of the three currently available agents has different pharmacological characteristics, safety, efficacy and costs. There has not been a direct comparison between eptifibatide and abciximab in the rates of major adverse cardiac events, major complications and thrombo-cytopenia. Methods. A total of 642 consecutive patients underwent PCI at our institution between January 2000 and December 2001 and were treated with either eptifibatide (n = 342) or abciximab (n = 300) during the procedure. The selection of the IIb/IIIa inhibitor was arbitrary and left to the discretion of the operator. Complete blood counts were performed by routine protocol on all patients 2 and 4 hours after initiation of the drug. We analyzed the in-hospital clinical outcomes and the incidence of thrombocytopenia in this cohort. Results. Baseline clinical and angiographic characteristics and concomitant drug treatment were similar between the 2 groups, except for a higher incidence of diabetes in the eptifibatide group. The rates of in-hospital death (1.2% eptifibatide group versus 1.0% abciximab group; p = 0.7), stroke (0% for both groups), target vessel revascularization (1.2% eptifibatide group versus 1.0% abciximab group; p = 0.8) and major bleeding complications (1.7% eptifibatide group versus 0.7% abciximab group; p = 0.2) were similar between the 2 groups. Thrombocytopenia was more frequent in the abciximab-treated patients (6%, versus 0% in the eptifibatide group; p <0.001), including 5 patients who developed profound thrombocytopenia (<20,000 cells/mm3). Conclusion. Both agents, eptifibatide and abciximab, proved to have the same rates of in-hospital major adverse cardiac events, bleeding and vascular complications. Abciximab therapy was associated with a significantly higher incidence of thrombocytopenia within 4 hours of drug initiation, which prompted immediate drug discontinuation, but was not associated with increased risk of bleeding, vascular or other complications.

Original languageEnglish (US)
Pages (from-to)319-323
Number of pages5
JournalJournal of Invasive Cardiology
Volume15
Issue number6
StatePublished - Jun 1 2003
Externally publishedYes

Keywords

  • Ischemic complications
  • Platelet glycoprotein IIb/IIIa receptor inhibitors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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