Temporal spectrum of ischemic complications with percutaneous coronary intervention: The ESPRIT experience

Warren J. Cantor, James E. Tcheng, James C. Blankenship, J. Conor O'Shea, Karen S. Pieper, Douglas A. Criger, Mina Madan, John Ducas, William S. Sheldon, Mark A. Tannenbaum, Jack E. Smith, Michael M. Kitt, Ian C. Gilchrist

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Abstract

We determined the timing of ischemic complications within 30 days after percutaneous coronary intervention (PCI) in patients enrolled in the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial. Complications (death, myocardial infarction [MI], target vessel revascularization) occurred in 178 of 2064 patients (8.6%) within 30 days. More than 85% of complications occurred within the 24 hours following randomization, with the greatest risk hazard at 12-18 hours. Unexpectedly, 31% of patients who ultimately met criteria for an endpoint MI within 24 hours of PCI had completely normal CK-MB concentrations at the first 6-hour measurement. There was no "rebound" increase in events after cessation of eptifibatide. Treatment benefit persisted to 30 days. Post-procedural MI is often not detected until ≥ 12 hours after PCI. Treatment with a glycoprotein IIb/IIIa inhibitor is the only modifiable parameter that reduces the risk for early ischemic complications.

Original languageEnglish (US)
Pages (from-to)475-481
Number of pages7
JournalJournal of Invasive Cardiology
Volume16
Issue number9
StatePublished - Sep 1 2004

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Cantor, W. J., Tcheng, J. E., Blankenship, J. C., O'Shea, J. C., Pieper, K. S., Criger, D. A., Madan, M., Ducas, J., Sheldon, W. S., Tannenbaum, M. A., Smith, J. E., Kitt, M. M., & Gilchrist, I. C. (2004). Temporal spectrum of ischemic complications with percutaneous coronary intervention: The ESPRIT experience. Journal of Invasive Cardiology, 16(9), 475-481.