A randomized, placebo-controlled trial of early eptifibatide for non-ST–segment elevation acute coronary syndromes - 28/08/11
, Robert H Christenson, PhD b, E.Magnus Ohman, MD a, Raymond Bahr, MD c, Francis M Fesmire, MD d, Alan Storrow, MD f, Michael Mollod, MD e, W.Frank Peacock, MD g, Jeffrey A Rosenblatt, MD h, Hongqiu Yang, MS a, Elizabeth S Fraulo, RN a, James W Hoekstra, MD i, W.Brian Gibler, MD fEARLY Investigators and Emergency Medicine Cardiac Research and Education Group (EMCREG)
Abstract |
Background |
The acute benefits of platelet glycoprotein IIb/IIIa inhibitors for non-ST–segment elevation acute coronary syndromes (NSTE ACS) remain unclear.
Methods |
In this pilot trial, 311 patients with NSTE ACS were randomly assigned in the emergency department to double-blinded therapy with eptifibatide or placebo for 12 to 24 hours before crossover to open-label eptifibatide. Serial creatine-kinase MB (CK-MB) and quantitative cardiac troponin T levels were collected during the first 24 hours to assess the impact of early platelet glycoprotein IIb/IIIa blockade on infarct size as measured by cardiac markers.
Results |
Median peak CK-MB (10.3 vs 11.8 ng/mL; P = .71) and peak quantitative cardiac troponin T levels (0.2 vs 0.3 ng/mL; P = .95) were similar between treatment groups, respectively. Median calculated peak CK-MB values (41 vs 40 ng/mL; P = .72) and area under the CK-MB curve measurements (980 vs 764 μg/min/L; P = .68) from curve-fitting analyses that could be performed in 106 of 311 patients were also similar.
Conclusions |
In this pilot trial, early administration of eptifibatide in the emergency department did not modulate serologic measurements of infarct size in patients with NSTE ACS.
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 | Funded by grants from COR Therapeutics, Inc, South San Francisco, Calif, and Roche Diagnostics Corporation, Indianapolis, Ind. Guest Editor for this manuscript was Judith S. Hochman, MD, St Luke's-Roosevelt Hospital, New York, NY. |
Vol 146 - N° 6
P. 993-998 - décembre 2003 Retour au numéro
Article précédent
- Hypertensive patients' willingness to participate in placebo-controlled trials: implications for recruitment efficiency
- Scott D Halpern, Jason H.T Karlawish, David Casarett, Jesse A Berlin, Raymond R Townsend, David A Asch
- Global patterns of use of antithrombotic and antiplatelet therapies in patients with acute coronary syndromes: insights from the Global Registry of Acute Coronary Events (GRACE)
- Andrzej Budaj, David Brieger, Ph Gabriel Steg, Shaun G Goodman, Omar H Dabbous, Keith A.A Fox, Alvaro Avezum, Christopher P Cannon, Tomasz Mazurek, Marcus D Flather, Frans Van De Werf, GRACE Investigators
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