Impact of Maintenance Dose of Eptifibatide in Patients with ST-Segment
Elevation Myocardial Infarction Who Underwent Primary Percutaneous
Coronary Intervention
Abstract
Aim: ST-segment elevation myocardial infarction (STEMI) is usually
caused by a rupture in the atherosclerotic plaque, followed by platelet
aggregation which ultimately leads to acute coronary artery occlusion.
In this study, we investigated the effect of maintenance dose of
Eptifibatide (intravenous drug of GP IIb/IIIa inhibitor) in patients
with STEMI who underwent primary percutaneous coronary intervention
(PPCI). Methods: 264 patients who had acute chest pain suggestive of
STEMI were entered in the study. All patients received the same dose of
bolus dose of eptifibatide. Then the patients were randomly divided into
two groups, one group (n=147) received a maintenance dose of intravenous
eptifibatide (infusion of 2g/kg/min) and the other group (n=117) did
not receive this treatment. All patients were evaluated 1 and 3 months
after the start of treatment in terms of predicted outcomes. Results:
The occurrence of three-month MACE between the case and control groups
did not have a statistically significant difference (28.6% versus
35.0% ; P-value: 0.286). Re-hospitalization occurred in 10 patients
(6.8%) from the case group and 30 patients (25.6%) from the control
group, which was statistically significant (P-value: 0.000). Also,
investigations showed that the rate of re-infarction (P-value: 0.024)
and target lesion revascularization (P-value: 0.003) was significantly
lower in the group that received Eptifibatide infusion. Conclusion:
Eptifibatide maintenance dose infusion in patients who undergo PPCI in
the context of STEMI, does not significantly reduce MACE, although it
does significantly reduce re-hospitalization and re-infarction. It also
does not increase the risk of bleeding and cerebrovascular events.