DALLAS -- For smaller community hospitals that routinely transfer their sicker heart attack patients to larger tertiary care facilities for advanced treatment, the immediate use of a new anti-platelet drug improves the odds that the patient will not die or suffer a second heart attack within 30 days.
Based on the results of their so-called "Drip and Ship" study, researchers from the Duke Clinical Research Institute (DCRI), further recommend that these smaller hospitals immediately begin infusion of the drug eptifibatide (trade name Integrilin) in their suspected heart attack patients with unstable angina, regardless of whether the hospital transfers the sicker patients to larger facilities.
The international 11,000-patient PURSUIT trial, the results of which were published this summer in the New England Journal of Medicine, demonstrated that eptifibatide significantly reduced the 30-day incidence of death or heart attack in heart patients who were admitted to the hospital with unstable coronary syndromes.
Since the majority of these patients are first seen in smaller community hospitals, the DCRI researchers wanted to know if it mattered when the drug was administered -- before or after transfer.
"For these smaller hospitals, the message is clear -- begin the drug immediately," said study author Dr. Adam Greenbaum. "Furthermore, the decision of whether or not to transfer should be based on clinical considerations. In some cases, it appears that starting the drug at the smaller hospital may even alleviate the need to transfer altogether."
Greenbaum, a cardiology fellow at the DCRI, prepared the results of his study for presentation Tuesday (Nov. 10) at the 71st scientific sessions of the American Heart Association meeting.
Eptifibatide, a class of drug known as platelet glycoprotein IIb/IIIa
inhibitors, interrupts the cascade of events that causes platelets circulating
in the blood t
Contact: Richard Merritt
Duke University Medical Center