A propensity analysis of the impact of platelet glycoprotein IIb/IIIa inhibitor therapy on in-hospital outcomes after percutaneous coronary intervention

Babak A. Vakili, Robert C. Kaplan, James N. Slater, Warren Sherman, Kumar L. Ravi, Stephen J. Green, Timothy A. Sanborn, David L. Brown

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

It is unknown whether the benefits of parenteral platelet glycoprotein (GP) IIb/IIIa inhibitors as an adjunct to percutaneous coronary intervention (PCI) demonstrated in randomized clinical trials extend to patients treated outside the setting of clinical trials. A contemporary registry of 10,847 consecutive PCI procedures was analyzed to determine the effect of GP IIb/IIIa inhibitor treatment on in-hospital major adverse coronary events ([MACEs] composite of death, urgent coronary artery bypass surgery, periprocedural myocardial infarction, abrupt closure, and stent thrombosis). In this registry, GP IIb/IIIa inhibitors were administered to 20.1% of patients. These patients were younger, more often men, and less often hypertensive than untreated patients. GP IIb/IIIa inhibitor-treated patients were more likely to present with acute myocardial infarction or unstable angina. Stents were placed in 79% of patients treated with GP IIb/IIIa inhibitors. MACEs occurred in 7.8% of GP IIb/IIIa inhibitor-treated patients compared with 3.8% of untreated patients (p <0.001). After multivariable adjustment for the propensity of GP IIb/IIIa inhibitor treatment as well as other possible confounders and interactions known to influence MACEs, GP IIb/IIIa inhibitor treatment was associated with a 57% increase in the risk of a MACE (odds ratio 1.57, 95% confidence interval 1.22 to 2.03; p = 0.0004). In a data set consisting of patients with a high degree of acuity predominantly treated with stent placement, GP IIb/IIIa inhibitor treatment is associated with an increase in thrombotic complications of PCI.

Original languageEnglish (US)
Pages (from-to)946-950
Number of pages5
JournalAmerican Journal of Cardiology
Volume91
Issue number8
DOIs
StatePublished - Apr 15 2003
Externally publishedYes

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Integrin beta3
Platelet Glycoprotein GPIIb-IIIa Complex
Percutaneous Coronary Intervention
Stents
Therapeutics
Registries
Myocardial Infarction
Unstable Angina
Coronary Artery Bypass
Thrombosis
Randomized Controlled Trials
Odds Ratio
Clinical Trials
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A propensity analysis of the impact of platelet glycoprotein IIb/IIIa inhibitor therapy on in-hospital outcomes after percutaneous coronary intervention. / Vakili, Babak A.; Kaplan, Robert C.; Slater, James N.; Sherman, Warren; Ravi, Kumar L.; Green, Stephen J.; Sanborn, Timothy A.; Brown, David L.

In: American Journal of Cardiology, Vol. 91, No. 8, 15.04.2003, p. 946-950.

Research output: Contribution to journalArticle

Vakili, Babak A. ; Kaplan, Robert C. ; Slater, James N. ; Sherman, Warren ; Ravi, Kumar L. ; Green, Stephen J. ; Sanborn, Timothy A. ; Brown, David L. / A propensity analysis of the impact of platelet glycoprotein IIb/IIIa inhibitor therapy on in-hospital outcomes after percutaneous coronary intervention. In: American Journal of Cardiology. 2003 ; Vol. 91, No. 8. pp. 946-950.
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