Effectiveness of Glycoprotein IIb/IIIa Inhibitor Use During Primary Coronary Angioplasty: Results of Propensity Analysis Using the New York State Percutaneous Coronary Intervention Reporting System

Vankeepuram S. Srinivas, Basel Skeif, Abdissa Negassa, Ji Yon Bang, Hussein Shaqra, E. Scott Monrad

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Patients undergoing primary angioplasty in clinical practice experience a higher risk for adverse events than those enrolled in clinical trials. Whether glycoprotein (GP) IIb/IIIa inhibitor use during primary angioplasty is both safe and effective in real life is unknown. Therefore, we examined the pattern of GP IIb/IIIa use and its effectiveness in a large population-based cohort of 7,321 patients who underwent primary angioplasty in New York State. Propensity analysis was used to account for the nonrandomized use of GP IIb/IIIa inhibitors. Overall, 78.5% of patients who underwent primary angioplasty received GP IIb/IIIa inhibitors. In-hospital mortality was significantly lower with GP IIb/IIIa use (3% vs 6.2%, p <0.0001) after adjustment for both propensity score (odds ratio 0.57, 95% confidence interval 0.44 to 0.74, p <0.0001) and the combination of propensity score and clinical characteristics (odds ratio 0.63, 95% confidence interval 0.45 to 0.88, p = 0.006). Patients with older age and higher Mayo Clinic Risk Score (MCRS) received GP IIb/IIIa inhibitors less often. However, stratified analysis of patients with low to moderate risk (MCRS <12) versus high risk (≥12) demonstrated that GP IIb/IIIa use lowered risk of mortality both in low- to moderate-risk (1.39% vs 3.23%, p <0.0001) and high-risk patients (16.15% vs 22.41%, p = 0.03). In conclusion, adjunct GP IIb/IIIa inhibitor use during primary angioplasty is effective and associated with improved in-hospital survival rates.

Original languageEnglish (US)
Pages (from-to)482-485
Number of pages4
JournalAmerican Journal of Cardiology
Volume99
Issue number4
DOIs
StatePublished - Feb 15 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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