Estudio aleatorizado con abciximab o eptifibatide en angioplastia coronaria compleja. Resultados intrahospitalarios y a 30 días

Abstract

Introduction and objectives The use of platelet glycoprotein IIb/IIIa inhibitors (IGP) in patients undergoing high risk percutaneous coronary angioplasty (PCA) is increasing. In this prospective randomized study we compare abciximab (ABX) vs eptifibatide (EPT). The primary endpoints were to compare the incidence of major adverse events during the first month after PCA (death, stroke, the need for revascularisation, and myocardial infarction) and vascular complications in both groups. Methods A total of 208 patients were recruited, and received abciximab (103) or eptifibatide (105) after the coronary angioplasty. Patients with non-ST acute coronary syndrome or angina with multivessel coronary disease and complex lesions were included. Patients with ST-segment elevation myocardial infarction of less than 24 h of clinical progression were excluded. Results Clinical characteristics and baseline angiographic findings were similar in ABX and EPT: diabetic: 35.9 versus 37.1%; multivessel coronary disease 79.6 vs 76.1%, respectively ( P=ns). No difference was observed in major adverse events: ABX 22 patients (21%) vs EPT 26 (24%), ( P=0.5). There was a death in the ABX group, probably due to a stent thrombosis at 15 days after PCA: Myocardial Infarction (Troponin I >1 ng/dl): 21 versus 26 patients ( P=0.45). There were some vascular complications in 8 patients on ABX and 4 on EPT ( P=0.22). There were no haemorrhagic complications or major bleeding. One minor and 3 slight bleedings were reported in each group. Conclusions No difference was observed between ABX and EPT in major adverse events during the first month after PCA, and there was a small percentage of bleeding complications in both groups.