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Comparison between Bolus Intracoronary versus Bolus Intravenous Injection Regimens of Eptifibatide during Primary Percutaneous Coronary Intervention in Patients with Anterior ST-Segment Elevation Myocardial Infarction

https://doi.org/10.20996/1819-6446-2019-15-1-17-28

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Abstract

Background. Eptifibatide achieves high local concentration via direct intracoronary (I/V) injection as it promotes clot disaggregation, but it remains unclear if it is of superior benefit than the routine intravenous (I/V) administration. Aim. The current study aimed to examine the safety and efficacy of I/C vs I/V bolus regimen dose of eptifibatide during primary percutaneous coronary intervention (PPCI).

Material and methods. Prospective, controlled, randomized study enrolled 100 patients with acute anterior ST-segment elevation myocardial infarction (STEMI) eligible for PPCI equally divided into 2 groups (group A received bolus I/C eptifibatide and group B received it I/V) followed by 12-hour continuous I/V infusion. Features related to of myocardial salvage in the form of TIMI flow grade 3, myocardial blush grade 3, ST segment resolution and left ventricular systolic function were evaluated with short-term follow up for 1 month.

Results. Mean age of the study population was 50.95±8.45years, there was statistically insignificant difference between both groups regarding baseline characteristics in age (p=0.062), gender (p=0.488), coronary artery disease risk factors (p>0.05), time from onset of pain to admission (p=0.86) or door to balloon (p=0.12). Group A achieved statistically significant better myocardial blush grade 3 (42% vs 10%, p=0.005), ejection faction 30 days after PPCI (46.11±7.81% vs 40.88±6.26%, p=0.005) but statistically insignificant TIMI flow grade 3 (p=0.29) and ST resolution (p=0.34). Incidence of complications in the hospital and 30 days after discharge was statistically insignificant (p>0.05).

Conclusion. Both regimens were safe and effective in STEMI patients undergoing PPCI and regimen of I/C bolus eptifibatide achieved better myocardial blush grade and systolic function. 

About the Authors

Mohamed Hassan Nab
National Heart Institute
Egypt

Consultant of Cardiovascular Medicine,

5 Ibn El Nafees Sq., Cairo, Giza Governorate



Shaimaa Mostafa
Benha University Hospital
Egypt

Assistant Professor of Cardiology, Department of Cardiology, Benha Faculty of Medicine,

Fareed Nada Street, Benha, Qalubiya Governorate, 13511



Khaled Elrabat
Benha University Hospital
Egypt

Assistant Professor of Cardiology, Department of Cardiology, Benha Faculty of Medicine,

Fareed Nada Street, Benha, Qalubiya Governorate, 13511



Hamza Kabil
Benha University Hospital
Egypt

Professor of Cardiovascular Medicine, Department of Cardiology,

Fareed Nada Street, Benha, Qalubiya Governorate, 13511



Neama Elmelegy
Benha University Hospital
Egypt

Consultant of Cardiovascular Medicine, Department of Cardiology,

Fareed Nada Street, Benha, Qalubiya Governorate, 13511



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For citation:


Nab M.H., Mostafa S., Elrabat K., Kabil H., Elmelegy N. Comparison between Bolus Intracoronary versus Bolus Intravenous Injection Regimens of Eptifibatide during Primary Percutaneous Coronary Intervention in Patients with Anterior ST-Segment Elevation Myocardial Infarction. Rational Pharmacotherapy in Cardiology. 2019;15(1):17-28. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-1-17-28

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ISSN 1819-6446 (Print)
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