Comparative efficacy of eptifibatide and abciximab in primary angioplasty study

Abstract

Background: Primary percutaneous intervention is the safest and most effective treatment modality for acute ST-segment elevation myocardial infarction (MI) in centers where catheterization facilities exist. Intravenous glycoprotein IIb/IIIa inhibitor therapy during the procedures has been proven to provide added benefits. For the two agents, abciximab and eptifibatide, commonly used in this context, there is only limited comparative data available for the clinicians. Hitherto, there is no data published from the Asia-Pacific region on this topic. Method: A retrospective comprehensive analysis was carried out, comparing patients who were treated with abciximab (n = 125) and eptifibatide (n = 125) during primary angioplasty over a 3-year period. The primary outcome measure was in-hospital mortality. The other outcome measures studied include MI, stroke, blood transfusion, contrast nephropathy, significant bleeding, and vascular complications. A comparative cost analysis was carried out to ascertain the average overall differential cost. Results: In-hospital mortality, MI, stroke, blood transfusion, contrast nephropathy, significant bleeding, and vascular complication were observed at a higher rate in the patients who were treated with abciximab. However, these differences did not reach statistical significance. Due to the higher cost per unit and longer hospital stay, therapy with abciximab costs more than that with eptifibatide. Conclusions: Both abciximab and eptifibatide are safe and effective adjunct therapeutic agents in the setting of primary angioplasty. However, there is a trend toward higher adverse event with the former agent that was not statistically significant. Therapy with abciximab costs more per patient.