Alternative Treatment in STEMI Patients Undergoing PCI Looks Promising
November 4, 2007 – A specific way of dosing eptifibatide appears equally effective as giving abciximab as an adjunct to primary percutaneous coronary intervention (PCI) in restoring blood flow to the heart, according to late-breaking clinical trial results announced at the American Heart Association’s Scientific Sessions 2007.
The EVA-AMI study (Eptifibatide Versus Abciximab in Primary PCI for Acute ST elevation Myocardial Infarction) compared the effectiveness of giving a double bolus of eptifibatide versus abciximab in achieving complete electrocardiographic ST resolution 60 minutes after PCI. (Complete ST resolution means a greater than 70 percent resolution of the ST segment elevation seen on the patient’s initial electrocardiogram.) Standard treatment after a heart attack often includes PCI, or angioplasty, to re-open the blocked artery that caused the attack. After PCI, patients are typically prescribed medicine to reduce the risk of blood clots. The drugs eptifibatide and abciximab are both glycoprotein IIb/IIIa inhibitors, which prevent platelets from sticking together to form blood clots.
“Complete ST resolution is a sign that blood is getting through to the heart muscle. It is closely related to 30-day and long-term mortality,” said Uwe Zeymer, lead author of the study, which was conducted out of Ludwigshafen, Germany. “Our results show there were no differences between the effectiveness of the two drugs.”
EVA-AMI is an international, multicenter, randomized, prospective, open parallel group comparison of the two drugs in patients undergoing primary PCI less than 12 hours after having a heart attack. The study included 430 patients in France and Germany between November 2006 and May 2007.
The patients were also taking clopidogrel (another antiplatelet) and aspirin, plus heparin (a blood thinner) or enoxaparin (a low molecular weight heparin), which are all part of standard treatment after a heart attack.
Support for this study was provided by Glaxo Smith Kline.
Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.
For more information: www.americanheart.org
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