dc.contributor.author | Rathod, KS | en_US |
dc.contributor.author | Antoniou, S | en_US |
dc.contributor.author | Avari, P | en_US |
dc.contributor.author | Ding, N | en_US |
dc.contributor.author | Wright, P | en_US |
dc.contributor.author | Knight, C | en_US |
dc.contributor.author | Jain, AK | en_US |
dc.contributor.author | Mathur, A | en_US |
dc.contributor.author | Smith, EJ | en_US |
dc.contributor.author | Weerackody, R | en_US |
dc.contributor.author | Wragg, A | en_US |
dc.contributor.author | Jones, DA | en_US |
dc.date.accessioned | 2018-03-07T14:03:40Z | |
dc.date.available | 2017-09-04 | en_US |
dc.date.issued | 2017-01 | en_US |
dc.date.submitted | 2018-02-19T13:33:53.119Z | |
dc.identifier.issn | 2048-0040 | en_US |
dc.identifier.other | 10.1177/2048004017734431 | |
dc.identifier.uri | http://qmro.qmul.ac.uk/xmlui/handle/123456789/34430 | |
dc.description.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. | en_US |
dc.format.extent | 2048004017734431 - ? | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | JRSM Cardiovasc Dis | en_US |
dc.rights | CC BY-NC | |
dc.subject | Acute coronary syndromes | en_US |
dc.subject | aetiology | en_US |
dc.subject | cardiology | en_US |
dc.subject | cardiovascular pharmacology | en_US |
dc.subject | treatment | en_US |
dc.title | 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. | en_US |
dc.type | Article | |
dc.rights.holder | 2017. The authors | |
dc.identifier.doi | 10.1177/2048004017734431 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/29051816 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
pubs.volume | 6 | en_US |
dcterms.dateAccepted | 2017-09-04 | en_US |