Comparative Study between Primary Percutaneous Coronary Intervention With and Without the Infusion of Eptifibatide Efficacy and Safety

Introduction: Primary percutaneous coronary intervention (PCI) is the most effective available method to restore coronary perfusion in acute STEMI, where normal coronary flow can be restored in 85% of patients. Several randomized clinical trials have shown that inhibition of platelet aggregation with platelet GP IIb/IIIa inhibitors improves outcome in patients undergoing primary PCI.Aim of the Work: To assess the benefit and the short term outcome of the use of Eptifibatide I.V Infusion in primary percutaneous coronary intervention.Patients and Methods: 40 consecutive patients with acute ST segment elevation myocardial infarction (STEMI) presenting within 12 hours of chest pain eligible for primary PCI. Divided into two groups: group A: 20 patients were managed by upstream Eptifibatide, group B: 20 patients were managed by primary PCI without the use of Eptifibatide infusion, short term MACE were determined in both group.Results: The baseline demographic and clinical data were similar in both group, Death occurred in 0% in group A and 10.5% in group B (p-value 0.220). Reinfarction occurred in 0% in group A and 11.8% in group B (p-value 0.19). TVR occurred in 0% of patients in group A and 5.9% in group B (0.45). Stroke occurred in 0% of patients in group A and 5.9% in group B (p-value 0.45). Stent thrombosis occurred in 0% of patients in group A and 17.6% in group B (p-value 0.08).Total MACE in group A is 0% and 0.473% in group B. (p-value 0.003).No cases of minor or major bleeding occurred in patients in group A. Only 3 cases of minor bleeding occurred in patients in group B in the form of vascular access site hematoma with no cases of major bleeding.Conclusion: The use of glycoprotein inhibitors Eptifibatide in primary PCI improves short term clinical outcome and reduces periprocedural ischemic complications without increase in bleeding.