Comparison of Routine Versus Selective Glycoprotein IIb/IIIa Inhibitors Usage in Primary Percutaneous Coronary Intervention (from the British Cardiovascular Interventional Society)

The role of glycoprotein IIb/IIIa inhibitors (GPI) in primary percutaneous coronary intervention (PPCI) remains uncertain. Previous analyses compare PPCI outcomes with clopidogrel plus GPI, versus without GPI. This does not reflect modern contemporary PPCI practice with ticagrelor or prasugrel. Nor...

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Bibliographic Details
Published in:The American journal of cardiology 2019-08, Vol.124 (3), p.373-380
Main Authors: Orzalkiewicz, Mateusz, Hodson, James, Kwok, Chun Shing, Ludman, Peter F., Giblett, Joel P., George, Sudhakar, Doshi, Sagar N., Khan, Sohail Q., Kinnaird, Timothy, Hildick-Smith, David, Townend, Jonathan N., Mamas, Mamas A., Calvert, Patrick A.
Format: Article
Language:English
Subjects:
Abciximab - therapeutic use
Angioplasty
Bailouts
Cardiology
Clinical outcomes
Clopidogrel
Clopidogrel - therapeutic use
Combined Modality Therapy
Confidence intervals
Drug Utilization - statistics & numerical data
Drug Utilization - trends
Eptifibatide - therapeutic use
Female
Glycoproteins
Humans
Independent sample
Inhibitors
Intervention
Male
Middle Aged
Mortality
Patients
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors - therapeutic use
Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors
Prasugrel Hydrochloride - therapeutic use
Stents
Strategy
Survival
Ticagrelor - therapeutic use
Uncertainty analysis
United Kingdom
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Summary:The role of glycoprotein IIb/IIIa inhibitors (GPI) in primary percutaneous coronary intervention (PPCI) remains uncertain. Previous analyses compare PPCI outcomes with clopidogrel plus GPI, versus without GPI. This does not reflect modern contemporary PPCI practice with ticagrelor or prasugrel. Nor does it answer the important question faced daily by PPCI operators: should GPI be used routinely or selectively? We aim to determine whether a strategy of routine use of GPI in contemporary PPCI practice is superior to selective GPI use. A total of 110,327 consecutive PPCIs performed in England were prospectively recorded in the British Cardiovascular Intervention Society Database (2009 to 2015). The cohort was divided into routine and selective GPI usage groups based on the PPCI operator's strategy, defined as GPI used in >75% and
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2019.05.010