Intracoronary vs. Intravenous Eptifibatide for Percutaneous Coronary Intervention

Intracoronary infusion was better at achieving glycoprotein IIb/IIIa receptor occupancy and, ultimately, post-PCI microvascular perfusion.

Myocardial infarction sometimes complicates percutaneous coronary intervention (PCI) despite intravenous infusion of a glycoprotein (GP) IIb/IIIa inhibitor. To explore whether intracoronary delivery of the GP IIb/IIIa inhibitor improves myocardial perfusion, researchers randomized 43 patients undergoing PCI for acute coronary syndromes (ACS) at a single center to either intravenous or intracoronary administration of two boluses of eptifibatide 10 minutes apart. Both groups received a standard maintenance dose intravenously for 18 hours. Platelet GP IIb/IIIa receptor occupancy and platelet aggregation were assessed using blood samples from the coronary sinus and the femoral artery.

Receptor occupancy, measured 30 to 60 seconds after administr…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI