Abstract
Whether the benefits that glycoprotein IIb/IIIa inhibitors confer in patients who undergo bare metal stent implantation extend to drug-eluting stents is unknown. We performed a prespecified subgroup analysis of the TAXUS IV study population to examine the effect of procedural glycoprotein IIb/IIIa inhibition during paclitaxel-eluting stent implantation on periprocedural creatine kinase-MB (CK-MB) levels. Glycoprotein (GP) IIb/IIIa inhibitors were administered to 57.7% of patients who had been randomized to receive the TAXUS stent and to 56.7% of those who had been randomized to receive the control stent. Among patients who received the TAXUS stent, the rate of CK-MB increases of >3 times the normal level was 2.6-fold higher in those who received a GP IIb/IIIa inhibitor than in those who did not (11.4% vs 4.4%, p = 0.0015). Composite rates of major adverse cardiac events and target vessel failure were also higher at 1 month in the GP IIb/IIIa group. By multivariate analysis, use of GP IIb/IIIa inhibitors during stenting with the TAXUS stent was an independent predictor of CK-MB increases >3 times the normal level. Further studies are warranted.
Publication types
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Clinical Trial
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Comparative Study
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Randomized Controlled Trial
MeSH terms
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Abciximab
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Angina, Unstable / blood
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Angina, Unstable / diagnostic imaging
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Angina, Unstable / therapy
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Antibodies, Monoclonal / therapeutic use
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Antineoplastic Agents, Phytogenic / pharmacology*
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Coated Materials, Biocompatible*
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Coronary Angiography
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Coronary Restenosis / prevention & control
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Creatine Kinase / blood
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Creatine Kinase, MB Form
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Double-Blind Method
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Drug Interactions
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Eptifibatide
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Female
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Follow-Up Studies
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Humans
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Immunoglobulin Fab Fragments / therapeutic use
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Isoenzymes / blood
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Male
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Middle Aged
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Myocardial Ischemia / diagnostic imaging
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Myocardial Ischemia / therapy*
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Myocardial Revascularization / instrumentation*
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Paclitaxel / pharmacology*
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Peptides / therapeutic use
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Platelet Aggregation Inhibitors / therapeutic use*
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Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
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Platelet Glycoprotein GPIIb-IIIa Complex / metabolism
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Stents*
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Tirofiban
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Treatment Outcome
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Tyrosine / analogs & derivatives
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Tyrosine / therapeutic use
Substances
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Antibodies, Monoclonal
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Antineoplastic Agents, Phytogenic
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Coated Materials, Biocompatible
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Immunoglobulin Fab Fragments
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Isoenzymes
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Peptides
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Platelet Aggregation Inhibitors
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Platelet Glycoprotein GPIIb-IIIa Complex
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Tyrosine
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Creatine Kinase
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Creatine Kinase, MB Form
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Tirofiban
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Eptifibatide
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Paclitaxel
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Abciximab