Search: WFRF:(Newby L. Kristin) >
Safety and efficacy...
Safety and efficacy of adjusted-dose eptifibatide in patients with acute coronary syndromes and reduced renal function
-
Melloni, Chiara (author)
-
- James, Stefan K. (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
-
White, Jennifer A. (author)
-
show more...
-
Giugliano, Robert P. (author)
-
Harrington, Robert A. (author)
-
Huber, Kurt (author)
-
Tricoci, Pierluigi (author)
-
Armstrong, Paul W. (author)
-
Van de Werf, Frans (author)
-
Montalescot, Gilles (author)
-
Califf, Robert M. (author)
-
Newby, L. Kristin (author)
-
show less...
-
(creator_code:org_t)
- Elsevier BV, 2011
- 2011
- English.
-
In: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 162:5, s. 884-892
- Related links:
-
https://urn.kb.se/re...
-
show more...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- Background Dose adjustment of renally excreted antithrombotic drugs is recommended for patients with reduced renal function. We examined the influence of dose modification on bleeding and efficacy. Methods Based on initial study drug infusion rate, Early GP IIb/IIIa Inhibition in non-ST-segment elevation acute coronary syndromes (EARLY ACS) patients were categorized into groups: standard dose (2 mu g/kg/min; estimated creatinine clearance [eCrCl] >= 50 ml/min), adjusted dose (1 mu g/kg/min; eCrCl <50 ml/min, per protocol), excess dose (2 mu g/kg/min; eCrCl <50 ml/min). We explored relationships among initial dosing, randomized treatment assignment, and bleeding and ischemic end points (96-h composite of death, myocardial infarction [MI], recurrent ischemia requiring urgent revascularization or thrombotic bailout, and 30-d death or MI). Results Of 8,708 patients with eCrCl and dosing data, 19% had eCrCl <50 ml/min. Of these, 13% received adjusted dose eptifibatide and 6% received an excess dose. Across all dosing groups, no significant reductions were found in ischemic end points between early versus delayed provisional eptifibatide (OR 1.14, 95% CI 0.80-1.65; OR 1.13, 95% CI 0.81-1.56, respectively, for 96-h and 30-d composite end points). Bleeding risk was not significantly increased in the early versus delayed provisional treatment group in either the adjusted (OR 1.50, 95% CI 0.95-2.39) or excess dose group (OR 1.67, 95% CI 0.85-3.39). There were no significant interactions between dose group and treatment strategy on bleeding or efficacy. Conclusion Similar to observations in practice, despite guidelines recommendations and protocol guidance, 34% of EARLY ACS patients with reduced renal function failed to receive an appropriately adjusted study drug infusion. Use of an appropriately adjusted eptifibatide infusion was not associated with expected reductions in bleeding among patients with renal insufficiency.
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Melloni, Chiara
-
James, Stefan K.
-
White, Jennifer ...
-
Giugliano, Rober ...
-
Harrington, Robe ...
-
Huber, Kurt
-
show more...
-
Tricoci, Pierlui ...
-
Armstrong, Paul ...
-
Van de Werf, Fra ...
-
Montalescot, Gil ...
-
Califf, Robert M ...
-
Newby, L. Kristi ...
-
show less...
- Articles in the publication
-
American Heart J ...
- By the university
-
Uppsala University