Back to Search Start Over

Trends of Use and Outcomes Associated With Glycoprotein-IIb/IIIa Inhibitors in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention.

Authors :
Gellatly, Rochelle M.
Connell, Cia
Tan, Christianne
Andrianopoulos, Nick
Ajani, Andrew E.
Clark, David J.
Nanayakkara, Shane
Sebastian, Martin
Brennan, Angela
Freeman, Melanie
O'Brien, Jessica
Selkrig, Laura A.
Reid, Christopher M.
Duffy, Stephen J.
Source :
Annals of Pharmacotherapy; May2020, Vol. 54 Issue 5, p414-422, 9p
Publication Year :
2020

Abstract

Background: Glycoprotein IIb/IIIa inhibitors (GPIs) are a treatment option in the management of acute coronary syndromes (ACSs). Evidence supporting the use of GPIs predates trials establishing the benefits of P2Y12 inhibitors, routine early invasive therapy, and thrombectomy devices in patients with ACS. Objective: The aim of this study was to determine trends in GPI use and their associated outcomes in contemporary practice. Methods: We assessed GPI use in patients with ACS undergoing percutaneous coronary intervention (PCI) from the Melbourne Interventional Group registry (2005-2013). The primary endpoint was the 30-day incidence of major adverse cardiovascular events (MACE). The safety endpoint was in-hospital major bleeding. Results: GPIs were used in 40.5% of 12 357 patients with ACS undergoing PCI. GPI use decreased over the study period (P for trend <0.0001). Patients were more likely to receive GPIs if they were younger, presented with a ST-elevation myocardial infarction (STEMI), had more complex (B2/C-type) lesions, and when thrombectomy devices were used (all P < 0.0001). MACE were higher in patients receiving GPI (4.9% vs 4.1%, P = 0.03). Propensity score matching revealed no difference in 30-day mortality and 30-day MACE (odds ratio [OR] = 1.00; 95% CI = 0.99-1.004 and OR = 1.01; 95% CI = 0.99-1.02, respectively). GPI use was associated with more bleeding complications (3.6% vs 1.8%, P < 0.0001). Conclusion and Relevance: GPI use in ACS patients undergoing PCI has declined, and use appears to be dictated by ACS type and lesion complexity, as opposed to high-risk comorbidities. GPI use was associated with a doubling in bleeding complications. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10600280
Volume :
54
Issue :
5
Database :
Complementary Index
Journal :
Annals of Pharmacotherapy
Publication Type :
Academic Journal
Accession number :
142582203
Full Text :
https://doi.org/10.1177/1060028019889550