Please use this identifier to cite or link to this item:
Title: Trends of use and outcomes associated with glycoprotein-IIb/IIIa inhibitors in patients with acute coronary syndromes undergoing percutaneous coronary intervention.
Author: Gellatly, R. M.
Connell, C.
Tan, C.
Andrianopoulos, N.
Ajani, A.
Clark, D. J.
Nanayakkara, S.
Sebastian, M.
Brennan, A.
Freeman, M.
O'Brien, J.
Selkrig, L. A.
Reid, C. M.
Duffy, S. J.
Issue Date: 2020
Publication Title: Annals of Pharmacotherapy
Volume: 54
Issue: 5
Start Page: 414
End Page: 422
Abstract: Background: Glycoprotein IIb/IIIa inhibitors (GPIs) are a treatment option in the management of acute coronary syndromes (ACSs). Evidence supporting the use of GPIs predates trials establishing the benefits of P2Y12 inhibitors, routine early invasive therapy, and thrombectomy devices in patients with ACS. Objective: The aim of this study was to determine trends in GPI use and their associated outcomes in contemporary practice. Methods: We assessed GPI use in patients with ACS undergoing percutaneous coronary intervention (PCI) from the Melbourne Interventional Group registry (2005-2013). The primary endpoint was the 30-day incidence of major adverse cardiovascular events (MACE). The safety endpoint was in-hospital major bleeding. Results: GPIs were used in 40.5% of 12 357 patients with ACS undergoing PCI. GPI use decreased over the study period (P for trend <0.0001). Patients were more likely to receive GPIs if they were younger, presented with a ST-elevation myocardial infarction (STEMI), had more complex (B2/C-type) lesions, and when thrombectomy devices were used (all P < 0.0001). MACE were higher in patients receiving GPI (4.9% vs 4.1%, P = 0.03). Propensity score matching revealed no difference in 30-day mortality and 30-day MACE (odds ratio [OR] = 1.00; 95% CI = 0.99-1.004 and OR = 1.01; 95% CI = 0.99-1.02, respectively). GPI use was associated with more bleeding complications (3.6% vs 1.8%, P < 0.0001). Conclusion and Relevance: GPI use in ACS patients undergoing PCI has declined, and use appears to be dictated by ACS type and lesion complexity, as opposed to high-risk comorbidities. GPI use was associated with a doubling in bleeding complications.
Description: Includes data from BHS
Internal ID Number: 01537
Health Subject: DRUGS
Type: Journal Article
Appears in Collections:Research Output

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.