Eptifibatide 1995-2001

Integrilin Trials - Free PowerPoint Slides
http://www.clinicaltrialresults.org/ua/integrilin/integrilin.htm 

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TCTMD Expert Presentations 

• ESPRIT Trial (6 month Results), by J. Tcheng
• Eptifibatide - How Effective and Safe is it in ACS? (PURSUIT and ESPIRIT) , by J. Tcheng

ACC Current Journal Review Sep/Oct 2001
Platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention. The ESPRIT Trial: a randomized controlled trial
J.C. O’Shea, G.E. Hafley, S. Greenberg, for the ESPRITInvestigators
pages 59
Abstract | Journal Format-PDF (50Kb)

Platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention: the ESPRIT trial: a randomized controlled trial
O'Shea JC, et al.
Jama 2001;285:2468-73
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11368699
Adjunctive eptifibatide therapy during coronary stent implantation in the ESPRIT trial provides benefit through 6-month follow-up.

One-year ESPRIT results show continued benefit with eptifibatide
One-year results of the ESPRIT trial show that the reduction in death/MI seen with eptifibatide vs placebo in coronary stent patients is maintained at 1 year, consistent with that seen at 48 hours, 30 days, and 6 months (Paris Course on Revascularization).

Effect of eptifibatide on angiographic complications during percutaneous coronary intervention in the IMPACT- (integrilin to minimize platelet aggregation and coronary thrombosis) II Trial
Blankenship JC, et al.
Am J Cardiol 2001;88:969-73
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11703991  

Pharmacodynamics and pharmacokinetics of eptifibatide in patients with acute coronary syndromes: prospective analysis from PURSUIT
Tardiff BE, et al.
Circulation 2001;104:399-405
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11468200 

Pharmacodynamics and pharmacokinetics of higher-dose, double-bolus eptifibatide in percutaneous coronary intervention
Gilchrist IC, et al.
Circulation 2001;104:406-11
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11468201 

Clinical pharmacology of higher dose eptifibatide in percutaneous coronary intervention (the PRIDE study)
Tcheng JE, et al.
Am J Cardiol 2001;88:1097-102
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11703951 

Comparative 30-day economic and clinical outcomes of platelet glycoprotein IIb/IIIa inhibitor use during elective percutaneous coronary intervention: Prairie ReoPro versus Integrilin Cost Evaluation (PRICE) Trial
Am Heart J 2001;141:402-9
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11231437 

Effect of glycoprotein IIb/IIIa receptor inhibition on angiographic complications during percutaneous coronary intervention in the ESPRIT trial
Blankenship JC, et al.
J Am Coll Cardiol 2001;38:653-8
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11527612
Eptifibatide during nonurgent coronary stent intervention only minimally (and insignificantly) reduces the incidence of angiographic complications and subsequent CK-MB elevations in patients developing an angiographic complication. The greater effect is to reduce myocardial infarction in patients undergoing otherwise uneventful coronary stent implantation as well as in the overall study population.

Emergency room administration of eptifibatide before primary angioplasty for ST elevation acute myocardial infarction and its effect on baseline coronary flow and procedure outcomes
Cutlip DE, et al.
Am J Cardiol 2001;88:A6, 62-4
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11423060

In-hospital costs of coronary stent implantation with and without eptifibatide (the ESPRIT Trial)
D.J. Cohen, J.C. O'Shea, C.M. Pacchiana, G. Levine, I. Sarembock, J. Slater, E. Conn, J. Smith, J.E. Tcheng
Am J Cardiol 2002;89:61-64
Full text via ScienceDirect :
http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=CONTENTS&_method=citationSearch&_piikey=S0002914901021658&_version=1&md5=9217d0ecd4ecfbd2e72d8a34a599d3fa 

ESPRIT -  Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trial. The ESPRIT Investigators. Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy
  Lancet 2000;356:2037-44
  http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0011145489 
ESPRIT study of eftifibatide (integrilin) in planned stent implantation was stopped early because of a 43% reduction in death or MI at 48 hours (p=0.0017).The primary composite endpoint of death, myocardial infarction, urgent target revascularization and thrombotic bailout glycoprotein IIb/IIIa inhibitor therapy within 48 hours of randomisation was reduced from 10.5% in the placebo group to 6.6% in the eptifibatide group. The secondary endpoint (at 30 days) was reduced from 10.5% to 6.8%. 
Trial News for Friday, December 22, 2000 at  http://www.theheart.org/index.cfm?doc_id=19902

PURSUIT - Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes 
 Kleiman NS et al. 
 Circulation 2000;101:751-57
 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010683348 
Eptifibatide reduced 30-day events in patients who had early PCI (11.6% versus 16.7%, P=0.01) but not in patients who did not (14.6% versus 15.6%, P=0.23).

PURSUIT - Management of patients with acute coronary syndromes in the United States by platelet glycoprotein IIb/IIIa inhibition. Insights from the platelet glycoprotein IIb/IIIa in unstable angina
  Lincoff AM et al.
  Circulation 2000;102:1093-100
  http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010973836 
  Click here to view the slides
Platelet glycoprotein IIb/IIIa receptor blockade with eptifibatide reduces the incidence of death or myocardial infarction among patients treated for acute ischemic syndromes without ST-segment elevation within the United States. Click here to view the article synopsis

PURSUIT - Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring In-hospital coronary artery bypass grafting
  Marso SP et al.
  Circulation 2000;102:2952-8
  http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0011113045 
  Figure 
Eptifibatide administration in patients undergoing in-hospital CABG with a recent episode of a non-ST-segment elevation acute coronary syndrome results in a significant reduction in death or MI that is evident at 7 days and persists through the 6-month follow-up without a significant increase in perioperative bleeding rates.

Impact of eptifibatide on early ischemic events in acute ischemic coronary syndromes: a review of the IMPACT II trial. Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis
Tcheng JE.
Am J Cardiol 1997;80:21B-28B.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9291242

Combined accelerated tissue-plasminogen activator and platelet glycoprotein IIb/IIIa integrin receptor blockade with Integrilin in acute myocardial infarction. Results of a randomized, placebo- controlled, dose-ranging trial. IMPACT-AMI Investigators
Ohman EM, et al.
Circulation 1997;95:846-54.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9054741

Effects of integrelin, a platelet glycoprotein IIb/IIIa receptor antagonist, in unstable angina. A randomized multicenter trial
Schulman SP, et al.
Circulation 1996;94:2083-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8901655

Early clinical experience with integrelin, an inhibitor of the platelet glycoprotein IIb/IIIa integrin receptor
Ohman EM, et al.
Eur Heart J 1995;16 Suppl L:50-5.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8869019

Immediate and reversible platelet inhibition after intravenous administration of a peptide glycoprotein IIb/IIIa inhibitor during percutaneous coronary intervention
Harrington RA, et al.
Am J Cardiol 1995;76:1222-7.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7503000