Eptifibatide in Coronary Intervention

Abstract

> You can observe a lot just by watching. > > —Yogi Berra A combination of anticoagulant and antiplatelet therapies is foundational to the safe conduct of percutaneous coronary intervention (PCI).1 This reflects the obligate disruption of coronary vessel integrity and the consequent potential for thrombosis related to PCI. Beginning over 2 decades ago, eptifibatide, an agent that blocks the glycoprotein IIb/IIIa receptor, has been evaluated in clinical trials to ameliorate the potential for PCI-related thrombosis and for improving procedural and clinical outcomes.2–7 Although the glycoprotein IIb/IIIa inhibitors have been proven to reduce thrombotic events complicating PCI (death, myocardial infarction, abrupt vessel closure, and stent thrombosis), treatment is accompanied by an increase in the incidence of bleeding events that are in turn associated with worsened cardiovascular outcomes.8–10 See Article by Gurm et al The ideal PCI antithrombotic regimen eliminates the potential for catheter and device thrombosis, maximizes the clinical efficacy of the procedure, and minimizes the risk of bleeding. The dramatic evolution in interventional device technologies of the past several decades, coupled with the availability of new antithrombotic agents, has remarkably improved procedure …