Platelet GP IIb/IIIa receptor inhibition by eptifibatide in non ST-elevation MI-acute coronary syndrome

ABSTRACT

Recent trials of platelet glycoprotein IIb/IIIa receptor inhibitors have improved our understanding to best use these powerful antiplatelet drugs in acute coronary syndrome. We tested the hypothesis that inhibition of GPIIb/IIIa platelet receptor with Eptifibatide is effective as an empiric therapy in patients with acute coronary syndrome who do not necessarily undergo immediate revascularization. Since Feb 2006 one hundred and ninety-six patients who had presented with non ST-elevation acute coronary syndrome [NSTE-ACS] were randomly assigned to receive Eptifibatide in addition to standard therapy, for up to 72 hours or routine standard therapy. The primary end point was composite of death and non-fatal myocardial infarction [MI] or urgent target vessel revascularization [TVR] in 30 days. The incidence of composite end point of death, non fatal MI and urgent TVR was significantly lower in Eptifibatide group than standard group [16% vs. 0% - P value <0.01],particularly in troponin positive subgroup of patients [27.8% vs. 0% - P value <0.01]. Any major adverse reaction such as major bleeding, stroke, or thrombocytopenia was not seen. Early administration of GP IIb/IIIa receptor inhibitor is recommended in patients with high-risk acute coronary syndrome