The Journal of Informed Pharmacotherapy 2002;11:412.
Vivian W.Y. Leung, B.Sc.(Pharm), Rubina Sunderji, Pharm.D., FCSHP, Peter J. Zed, Pharm.D., Ken Gin, M.D., FRCPC
Pharmaceutical Sciences Clinical Service Unit, Vancouver General Hospital , Vancouver Hospital and Health Sciences Center, Vancouver, British Columbia, Canada
Canadian Society of Hospital Pharmacists (British Columbia Branch) Residency Research Presentation Night, Vancouver, British Columbia, Canada. May 8, 2002.
Glycoprotein IIb/IIIa inhibitors (GPI) are recommended as adjunctive therapy with percutaneous coronary interventions (PCI). Only abciximab (AB) was available at our institution until October 2000. Thereafter, eptifibatide (EP) was added to formulary and became the preferred agent due to lower cost. Our objective was to describe the impact of switching from AB to EP on prescribing patterns and clinical outcomes following PCI.
A major Canadian tertiary adult acute care teaching hospital.
Charts of patients who received a GPI with PCI for various indications were reviewed retrospectively. The AB group spanned the 6 months preceding formulary addition of EP in October 2000. A matching number of consecutive patients following this date were included in the EP group.
A total of 160 patients were included (80 per group). Adjunctive GPI usage increased from 11% to 25% of PCI within three months of adding EP to formulary (p<0.001). Compared to AB, EP was associated with more in-hospital ischemic complications (12.5% vs. 2.5%, p<0.025) and minor bleeding (p=ns). Premature GPI discontinuation was more common in the EP group (46.3% vs. 7.5%, p<0.001). Eptifibatide patients had a longer length of hospital stay post-PCI (mean 44.4h vs. 25.1h, p<0.0001).
Adjunctive GPI usage more than doubled following introduction of EP to the formulary. Eptifibatide may be associated with inferior clinical outcomes compared to AB for PCI.
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