11517
document
Treatment effects of eptifibatide in planned coronary stent implantation in patients with chronic kidney disease ( ESPRIT Trial ) . The role of platelet glycoprotein IIb/IIIa inhibitor therapy in patients with mild renal impairment is not well characterized . Our objective was to explore the associations of creatinine clearance ( CrCl ) with outcomes in a trial of eptifibatide therapy in patients who underwent percutaneous coronary intervention ( PCI ) . We analyzed 48-hour and 30-day outcomes of patients enrolled in the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy ( ESPRIT ) trial . Patients were randomly assigned to placebo or eptifibatide as an adjunct to stent implantation ( 1,755 with CrCl > or =60 ml/min and 289 with CrCl < 60 ml/min ) . CrCl was calculated using the Cockcroft and Gault formula , and the associations of CrCl with outcomes were evaluated using logistic regression models . Patients with CrCl < 60 ml/min were more likely to be older , women , hypertensive , and have a history of coronary artery bypass surgery , stroke , or peripheral vascular disease . The interaction of eptifibatide with CrCl had borderline significance for the 30-day outcome ( p = 0.109 ) . Treatment effect trended toward a greater magnitude in patients with lower CrCl ( 60 ml/min ) ( odds ratio 0.53 , confidence interval 0.34 to 0.83 ) compared with those with higher CrCl ( 90 ml/min ) ( odds ratio 0.68 , confidence interval 0.49 to 0.94 ) . An accompanying increase in bleeding risk also was not apparent with lower CrCl . The treatment effect of eptifibatide is realized regardless of renal function and trends toward being greater in patients with mild renal impairment .
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Intervention_Pharmacological
eptifibatide
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Intervention_Pharmacological
platelet glycoprotein IIb/IIIa inhibitor therapy
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Intervention_Pharmacological
eptifibatide therapy
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Intervention_Physical
Integrilin Therapy ( ESPRIT ) trial
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Intervention_Control
placebo
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Intervention_Pharmacological
eptifibatide
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Intervention_Pharmacological
eptifibatide
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Outcome_Other
associations of creatinine clearance ( CrCl )
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Outcome_Physical
CrCl
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Outcome_Other
the Cockcroft and Gault formula
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Outcome_Physical
CrCl
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Outcome_Other
logistic regression models
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Outcome_Adverse-effects
bleeding risk
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Outcome_Physical
renal impairment