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Rathod KS, Antoniou S, Avari P, et al. Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients. JRSM Cardiovasc Dis. 2017;6:2048004017734431doi: 10.1177/2048004017734431.
Rathod, K. S., Antoniou, S., Avari, P., Ding, N., Wright, P., Knight, C., Jain, A. K., Mathur, A., Smith, E. J., Weerackody, R., Wragg, A., & Jones, D. A. (2017). Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients. JRSM cardiovascular disease, 62048004017734431. https://doi.org/10.1177/2048004017734431
Rathod, K S, et al. "Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients." JRSM cardiovascular disease vol. 6 (2017): 2048004017734431. doi: https://doi.org/10.1177/2048004017734431
Rathod KS, Antoniou S, Avari P, Ding N, Wright P, Knight C, Jain AK, Mathur A, Smith EJ, Weerackody R, Wragg A, Jones DA. Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients. JRSM Cardiovasc Dis. 2017 Oct 05;6:2048004017734431. doi: 10.1177/2048004017734431. eCollection 2017. PMID: 29051816; PMCID: PMC5637964.
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JRSM Cardiovasc Dis. 2017 Oct 05;6:2048004017734431. doi: 10.1177/2048004017734431. eCollection 2017.

Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients.

JRSM cardiovascular disease

K S Rathod, S Antoniou, P Avari, N Ding, P Wright, C Knight, A K Jain, A Mathur, E J Smith, R Weerackody, A Wragg, D A Jones

Affiliations

  1. Department of Cardiology, Barts Health NHS Trust, London, UK.
  2. Department of Clinical Pharmacology, Queen Mary University, London, UK.
  3. NIHR Cardiovascular Biomedical Research Centre, Barts Health NHS Trust, London, UK.
  4. Department of Pharmacy, Barts Health NHS Trust, London, UK.

PMID: 29051816 PMCID: PMC5637964 DOI: 10.1177/2048004017734431

Abstract

INTRODUCTION: Glycoprotein IIb/IIIa inhibitors are recommended by guidelines in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. There are few studies directly comparing these agents. The aim of this study was to assess whether eptifibatide is a safe and cost-effective alternative to abciximab in the treatment of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

METHODS: This was an observational cohort study of 3863 patients who received a GPIIb/IIIa inhibitor whilst undergoing primary percutaneous coronary intervention from 2007 to 2014. Patients who did not receive a GPIIb/IIIa inhibitor were excluded. Time to first major adverse cardiac event defined as death, non-fatal myocardial infarction, stroke or target vessel revascularization, and total hospital costs were compared between the groups.

RESULTS: In all, 1741 patients received abciximab with 2122 receiving eptifibatide. Patients who received eptifibatide had higher rates of previous MI/percutaneous coronary intervention and were more likely to undergo a procedure from the radial route. Unadjusted Kaplan-Meier analysis revealed no significant difference in the 1-year event rates between patients given eptifibatide versus abciximab (p = 0.201). Age-adjusted Cox analysis demonstrated no difference in 1-year outcome between abciximab and eptifibatide (hazard ratio: 0.83; 95% confidence interval: 0.73-1.39), which persisted after multivariate adjustment (hazard ratio: 0.92; 95% confidence interval: 0.79-1.56) including the incorporation of a propensity score (hazard ratio: 0.88; 95% confidence interval: 0.71-1.44). Eptifbatide was associated with significant cost savings being 87% cheaper overall compared to abciximab (on average £650 cheaper per patient and saving approximately £950,000).

CONCLUSION: This observational data suggest that eptifibatide is associated with similar outcomes and significant cost savings compared to abciximab when used in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Keywords: Acute coronary syndromes; aetiology; cardiology; cardiovascular pharmacology; treatment

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