Background
Routine use of glycoprotein IIb/IIIa inhibitors (GPI) reduces ischemic events during PCI, but this benefit appears to be negated by excessive bleeding complication and thrombocytopenia and did not translate into mortality benefit in any randomized clinical trial (RCT). In 2009, we altered our protocol of GPI use. Via our continuous quality improvement program, we evaluated the effect of this intervention on clinical events.
Methods
Commencing February 2009, the following strategies were employed: (a) Prior to GPI administration, patients were assessed for bleeding propensity. (b) Eptifibatide was the only GPI used. (c) Bolus only or bolus and abbreviated (<8 h) drip GPI were preferred over the traditional 18-h administration. Both major ischemic and bleeding events as well as adjunctive therapy were recorded.
Methods
Commencing February 2009, the following strategies were employed: (a) Prior to GPI administration, patients were assessed for bleeding propensity. (b) Eptifibatide was the only GPI used. (c) Bolus only or bolus and abbreviated (<8 h) drip GPI were preferred over the traditional 18-h administration. Both major ischemic and bleeding events as well as adjunctive therapy were recorded.
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