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Titolo:
Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trial
Autore:
Tcheng, JE; OShea, JC; Cohen, EA; Pacchiana, CM; Kitt, MM; Lorenz, TJ; Greenberg, S; Strony, J; Califf, RM; Buller, C; Cantor, WJ; Joseph, DM; Kitt, MM; Lincoff, AM; Madan, M; Popma, J; Teirstein, P; Cohen, E; Balleza, L; Parsons, P; Lui, H; Young, J; Fox, R; Labinaz, M; Jelley, J; Williams, J; Cohen, D; Trovato, M; Smith, J; Henry, P; Chisholm, R; ODonnell, D; Talley, JD; Pacheco, R; Timmis, S; Muraka, A; Mann, T; Cubeddu, G; Tannenbaum, M; Greene, J; Santoian, E; Wash, M; Sheldon, S; Pronesti, L; Jain, A; Alonzo, M; Seidelin, P; Richards, J; Lopez, M; Dittenber, R; Johnson, K; Levine, G; Maresh, K; Ferrando, T; Sarembock, I; Snyder, L; Kieval, J; Herlan, L; Miller, M; Bembridge, D; Nair, R; Hickel, L; Kiernan, F; Murphy, D; Cloutier, J; Conn, E; Beardsley, J; Ritchie, M; Cragen, D; Jafar, MZ; Counihan, P; Rosenfelder, D; Ducas, J; Montebruno, L; Carere, R; Radons, B; Williams, L; Owens, W; Dougal, R; Feldman, R; Audrain, D; Karamali, A; Smith, M; Blankenship, J; Demko, SL; Thompson, M; Gacoich, G; Chiodo, V; Noll, P; Ledley, G; Miller, C; Felten, W; Garner, B; Chandler, AB; Easler, P; Albin, G; Page, A; Maddox, W; Allen, S; Gilchrist, I; Moore, R; Zimmerman, H; Curtis, M; Hildebrand, K; Greene, R; Healy, E; Meengs, W; Carson, D; George, J; Roncevich, T; Aharonian, V; Browning, R; Kostuk, W; Carr, S; Feit, F; Gostomsky, B; Butman, S; Hannah, E; Hassel, CD; Hartley, D; Shook, T; Hiller-Mullin, S; Brill, D; Dillion, M; Armstrong, B; Kerns, D; Pichard, A; Okubagzi, P; Nasser, T; Driver, L; Garrett, J; Boltey, L; Stouffer, G; Potter, M; Amidon, T; Eggert, S; Taussig, A; Potter, K; Natarajan, M; Tartaglia, C; Werner, J; Dunlap, T; Harrold-Runge, P; Davidson, C; Goodreau, L; Herzog, W; Calamunci, N; Slater, A; Tormey, D; Phillips, W; White, D; Sridhar, K; White, J; Goodman, D; Buchbinder, M; Nasser, V; Rapeport, K; Vorman, P; Weiner, B; Borbone, M; Shadoff, N; Paap, C; Rehman, A; Haag, E; Burchenal, J; Kioussopoulos, K; Senior, D; Senior, J; Piana, R; Kirshenbaum, J; Chan, S; Chowdry, A; Kraft, P; Clark, V; Fox, M; Deutsch, E; Shannon, T; Quesada, R; Brotherton, J; Murrin, C; Cinderella, J; Hearne, S; Seefried, V; Farah, T; Pakstis, D; Bartolet, B; Bond, C; Debarardinis, C; Montory, D; Smith, G; Gray, D; Phillips, P; Hathaway, S; Manoukian, S; Patrick, C; Yakubov, S; Brooks, J; Block, P; Block, B; Muhlestein, JB; Kim, S; Shalev, Y; Schmidt, W; Resar, J; Citro, K; Stine, R; Zumbuhl, J; Moreyra, A; Kreiger, S; Berger, P; Cannon, CP; Fisher, L; Hasselblad, V; Foster, A; Joseph, D; Madan, M; McLendon, C; Rund, M; Tillery, N; Wood, F; Mahaffey, KW; Irwin, C; Kulick, D; Johnson, N; Chen, J; Greenberg, S; Hogeboom, C; Lorenz, TJ; Terifay, R; Strony, J; Veltri, E;
Indirizzi:
Duke Univ, Med Ctr, Durham, NC 27710 USA Duke Univ Durham NC USA 27710Duke Univ, Med Ctr, Durham, NC 27710 USA Sunnybrook & Womens Coll, Hlth Sci Ctr, Toronto, ON, Canada Sunnybrook & Womens Coll Toronto ON Canada Sci Ctr, Toronto, ON, Canada Jackson Madison Cty Gen Hosp, Jackson, TN 38301 USA Jackson Madison Cty Gen Hosp Jackson TN USA 38301 , Jackson, TN 38301 USA Vancouver Gen Hosp, Vancouver, BC, Canada Vancouver Gen Hosp Vancouver BCCanada r Gen Hosp, Vancouver, BC, Canada Univ Ottawa, Inst Heart, Ottawa, ON, Canada Univ Ottawa Ottawa ON CanadaUniv Ottawa, Inst Heart, Ottawa, ON, Canada Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 r, Boston, MA 02215 USA St Vincent Hosp, Erie, PA 16501 USA St Vincent Hosp Erie PA USA 16501St Vincent Hosp, Erie, PA 16501 USA St Michaels Hosp, Toronto, ON M5B 1W8, Canada St Michaels Hosp Toronto ONCanada M5B 1W8 p, Toronto, ON M5B 1W8, Canada Univ Hosp Arkansas, Cent Arkansas Vet Healthcare, 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USA 15224 Hosp, Pittsburgh, PA 15224 USA Kaiser Los Angeles Med Ctr, Los Angeles, CA 90027 USA Kaiser Los Angeles Med Ctr Los Angeles CA USA 90027 Angeles, CA 90027 USA London Hlth Sci Ctr Univ, London, ON, Canada London Hlth Sci Ctr Univ London ON Canada i Ctr Univ, London, ON, Canada NYU, Med Ctr, New York, NY 10016 USA NYU New York NY USA 10016NYU, Med Ctr, New York, NY 10016 USA Univ Arizona, Med Ctr, Tucson, AZ 85724 USA Univ Arizona Tucson AZ USA 85724 v Arizona, Med Ctr, Tucson, AZ 85724 USA Baptist Med Ctr, Jacksonville Beach, FL 32240 USA Baptist Med Ctr Jacksonville Beach FL USA 32240 ville Beach, FL 32240 USA Hosp Good Samaritan, Los Angeles, CA 90017 USA Hosp Good Samaritan Los Angeles CA USA 90017 n, Los Angeles, CA 90017 USA Washington Adventist Hosp, Tacoma Pk, MD 20912 USA Washington Adventist Hosp Tacoma Pk MD USA 20912 Tacoma Pk, MD 20912 USA Holston Valley Hosp & Med Ctr, Kingsport, TN 37660 USA Holston Valley Hosp& Med Ctr Kingsport TN USA 37660 gsport, TN 37660 USA 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Roosevelt Hosp New York NY USA 10019 osp, New York, NY 10019 USA Wilson Reg Med Ctr, Johnson City, NY 13790 USA Wilson Reg Med Ctr JohnsonCity NY USA 13790 , Johnson City, NY 13790 USA London Hlth Sci Ctr Victoria, London, ON, Canada London Hlth Sci Ctr Victoria London ON Canada ctoria, London, ON, Canada Scripps Mem Hosp, La Jolla, CA 92037 USA Scripps Mem Hosp La Jolla CA USA92037 s Mem Hosp, La Jolla, CA 92037 USA Alvarado Hosp, Med Ctr, San Diego, CA 92107 USA Alvarado Hosp San Diego CA USA 92107 sp, Med Ctr, San Diego, CA 92107 USA Univ Massachusetts, Med Ctr, Worcester, MA 01605 USA Univ Massachusetts Worcester MA USA 01605 ed Ctr, Worcester, MA 01605 USA Presbyterian Heart Grp, Albuquerque, NM 87101 USA Presbyterian Heart Grp Albuquerque NM USA 87101 Albuquerque, NM 87101 USA St Francis Hosp, Roslyn, NY 11576 USA St Francis Hosp Roslyn NY USA 11576St Francis Hosp, Roslyn, NY 11576 USA Univ Colorado, Ctr Hlth, Denver, CO 80206 USA Univ Colorado Denver CO USA80206 olorado, Ctr 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Titolo Testata:
LANCET
fascicolo: 9247, volume: 356, anno: 2000,
pagine: 2037 - 2044
SICI:
0140-6736(200012)356:9247<2037:NDROEI>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLATELET GLYCOPROTEIN-IIB/IIIA; REVASCULARIZATION PROCEDURES; IIB-IIIA; INTERVENTION; THERAPY; MULTICENTER; INHIBITION; BLOCKADE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Tcheng, JE Duke Univ, Med Ctr, Box 3275, Durham, NC 27710 USA Duke Univ Box 3275 Durham NC USA 27710 75, Durham, NC 27710 USA
Citazione:
J.E. Tcheng et al., "Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trial", LANCET, 356(9247), 2000, pp. 2037-2044

Abstract

Background The platelet glycoprotein IIb/IIIa inhibitors, although effective in reducing ischaemic complications of percutaneous coronary intervention. are used in few coronary stent implantation procedures. ESPRIT (EnhancedSuppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy) is a randomised, placebo-controlled trial to assess whether a novel, double-bolus dose of eptifibatide could improve outcomes of patients undergoing coronary stenting. Methods We recruited 2064 patients undergoing stent implantation in a native coronary artery. Immediately before percutaneous coronary intervention, patients were randomly allocated to receive eptifibatide, given as two 180 mug/kg boluses 10 min apart and a continuous infusion of 2.0 mug/kg/min for18-24 h, or placebo, in addition to aspirin, heparin, and a thienopyridine. The primary endpoint was the composite of death, myocardial infarction, urgent target vessel revascularisation, and thrombotic bailout glycoprotein IIb/IIIa inhibitor therapy within 48 h after randomisation. The key secondary endpoint was the composite of death, myocardial infarction, or urgent target vessel revascularisation at 30 days. Findings The trial was terminated early for efficacy. The primary endpointwas reduced from 10.5% (108 of 1024 patients on placebo [95% CI 8.7-12.4%]) to 6.6% (69 of 1040 [5.1-8.1%]) with treatment (p=0.0015). The key 30 daysecondary endpoint was also reduced, from 10.5% (107 of 1024 patients on placebo [8.6-12.3%]) to 6.8% (71 of 1040 [5.3-8.4%]; p=0.0034). There was consistency in reduction of events across all components of the composite endpoint and among the major subgroups. Major bleeding was infrequent but arose more often with eptifibatide than placebo (1.3%, 13 of 1040 [0.7-2.1%]) vs 0.4%, 4 of 1024 [0.1-1.0%]; p=0.027). Interpretation Routine glycoprotein IIb/IIIa inhibitor pretreatment with eptifibatide substantially reduces ischaemic complications in coronary stentintervention and is better than a strategy of reserving treatment to the bailout situation.

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Documento generato il 13/07/20 alle ore 04:36:25