Glycoprotein IIb/IIIa inhibitors

Abciximab (chimaeric human/murine Fab fragment)
Tirofiban
Eptifibatide

Indications

(NICE September 2000)
  1. unstable angina (recurrent chest pain, transient ST elevation, raised troponin, haemodynamic instability, post-MI)
  2. non-Q wave MI
  3. PTCA

Mode of administration

Continuous intravenous infusion. Concurrent aspirin + low dose unfractionated heparin.

Adverse effects

Evidence

Unstable angina: PRISM trial: NNT 11 at 30/7 (outcome death or AMI).
PTCA: EPIC, EPISTENT, CAPTURE trials.

Cost

Additional 17 million/year + additional cost of troponin testing.