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Bolus-only versus bolus + infusion of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention
- Source :
- American heart journal. 156(3)
- Publication Year :
- 2007
-
Abstract
- The present study was done to analyze if glycoprotein IIb/IIIa inhibitors (GPI) bolus-only will reduce vascular/bleeding complications and cost with similar major adverse cardiac events (MACE) when compared with GPI bolus + infusion. Evidence-based therapy of GPI inhibitors during percutaneous coronary intervention (PCI) incorporates intravenous bolus followed by 12 to 18 hours of infusion. However, GPI bolus + infusion may increase vascular/bleeding complications and may not reduce MACE when compared with GPI bolus-only.From January 1, 2003, to December 31, 2004, 2,629 consecutive patients received GPI during PCI at a single center. Of these, 1,064 patients received GPI bolus + infusion in 2003 and were compared with 1,565 patients that received GPI bolus-only in 2004. Baseline characteristics were similar in both groups.Patients receiving GPI bolus-only had reduced vascular/bleeding complications when compared with bolus + infusion (4.9% vs 7%, P.05, odds ratio 0.62, 95% confidence interval 0.45-0.89). Furthermore, ischemic complications were similar in both groups, including periprocedural creatine kinase-MB enzyme release (12.8% vs 15.3%, P = NS), MACE at 30 days (3.2% vs 3%, P = NS), and death and myocardial infarction at 1 year (7.1% vs 7.8%, P = NS). In addition, GPI bolus-only reduced cost in US dollars ($323 vs $706, P.001) and increased ambulatory PCI (13.1% vs 3.2%, P.01), with reduced length of stay (1.1 vs 1.6 days, P.01), when compared with GPI bolus + infusion.Glycoprotein inhibitor bolus-only reduces vascular/bleeding complications with similar MACE and reduced cost when compared with GPI bolus + infusion. In addition, GPI bolus-only improved ambulatory PCI and reduced length of stay. These results are consistent with a safer and cost-effective strategy for bolus-only when GPI therapy is considered during PCI.
- Subjects :
- medicine.medical_specialty
Heart Diseases
medicine.medical_treatment
Abciximab
Myocardial Ischemia
Eptifibatide
Hemorrhage
Platelet Glycoprotein GPIIb-IIIa Complex
Single Center
Cohort Studies
Immunoglobulin Fab Fragments
Bolus (medicine)
Internal medicine
Angioplasty
Ambulatory Care
Medicine
Humans
cardiovascular diseases
Myocardial infarction
Vascular Diseases
Angioplasty, Balloon, Coronary
Infusions, Intravenous
business.industry
Percutaneous coronary intervention
Antibodies, Monoclonal
Health Care Costs
Length of Stay
medicine.disease
Surgery
carbohydrates (lipids)
Glycoprotein IIb/IIIa inhibitors
Conventional PCI
Injections, Intravenous
Cardiology
lipids (amino acids, peptides, and proteins)
Cardiology and Cardiovascular Medicine
business
Peptides
Mace
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 10976744
- Volume :
- 156
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- American heart journal
- Accession number :
- edsair.doi.dedup.....929b41388447333e2264b3bc4213f3aa