Glycoprotein IIb/IIIa Inhibition in Acute Coronary Syndromes: Earlier Is Not Better

In the EARLY ACS trial, a provisional strategy was safer than routine use before invasive procedures.

The optimal use and timing of glycoprotein IIb/IIIa inhibitors for invasive procedures in patients with acute coronary syndromes is debated. Should such treatment be provisional or routinely given to all patients before the procedure? To find out, investigators conducted the international, manufacturer-funded Early Glycoprotein IIb/IIIa Inhibition in Non–ST-Segment-Elevation Acute Coronary Syndrome (EARLY ACS) trial.

Included were 9406 high-risk patients (elevated troponin, 84%; one quarter older than 75) with non–ST-segment-elevation ACS. Participants were randomized to receive either eptifibatide or matching placebo ≥12 hours before angiography, with provisional use of eptifibatide (for early-placebo recipients) or placebo (for early-eptif…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)