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1 at time of writing, Cardiology Specialty Resident, University of Pittsburgh
Medical Center, Pittsburgh, PA; now, Clinical Specialist, Cardiology,
Department of Pharmacy, Allegheny General Hospital, Pittsburgh
2 Assistant Professor, School of Pharmacy, University of Pittsburgh,
Pittsburgh
3 Department of Medicine, University of Pittsburgh
4 Associate Professor, Schools of Pharmacy and Psychiatry, University of
Pittsburgh
5 Assistant Professor, School of Pharmacy, University of Pittsburgh; Center for
Pharmacoinformatics and Outcomes Research, Pittsburgh
Reprints: Dr. Coons, Department of Pharmacy, Allegheny General Hospital, 320 E. North Ave., Pittsburgh, PA 15212-4772, fax 412/359-4806, jcoons{at}wpahs.org
BACKGROUND: Patients undergoing percutaneous coronary intervention (PCI) with stent placement are often prescribed glycoprotein IIb/IIIa inhibitors. However, drug selection is often based on clinicians' preference and cost because few studies have directly compared abciximab and eptifibatide.
OBJECTIVE: To compare clinical outcomes and total hospital costs of abciximab and eptifibatide in patients undergoing stent placemen during PCI in a real-world setting.
METHODS: A retrospective cohort analysis was conducted of 960
patients administered abciximab or eptifibatide for intracoronary stent
placement between 1999 and 2001 at a tertiary care hospital. The primary
outcome was bleeding, defined as major, moderate, or minor according to
published criteria. Secondary outcomes included in-hospital death, myocardial
infarction, revascularization, and the triple composite endpoint of those
outcomes, thrombocytopenia, length-of-stay, and total hospital costs.
Pearson's 
2 analysis, Fisher's exact test, and ANOVA
were used for statistical analysis.
RESULTS: The frequency of bleeding complications based on severity was similar between abciximab and eptifibatide: major (2.4% vs 2.8%), moderate (12.4% vs 10.5%), and minor (4.0% vs 3.9%), respectively (p = 0.86). Secondary clinical outcomes were also similar between groups (p > 0.05). Total costs for hospitalization were significantly greater for abciximab compared with eptifibatide ($16 383 ± 6799 vs $14 115 ± 6285; p < 0.001). Drug acquisition costs were also significantly greater for abciximab compared with eptifibatide ($508 ± 159 vs $465 ± 263; p = 0.003).
CONCLUSIONS: In patients undergoing stent placement during PCI, abciximab and eptifibatide are comparable in terms of safety and effectiveness despite significant differences in hospitalization and acquisition costs.
Key Words: abciximab, eptifibatide, percutaneous coronary intervention, stent
Published Online, August 16, 2005. www.theannals.com, DOI 10.1345/aph.1G129
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