Two drugs equally effective for heart patients undergoing angioplasty

In lifesaving procedures to open blocked heart arteries a key question has persisted for years: Is use of the more expensive drug, abciximab, justified over use of the less-expensive eptifibatide?

A new Mayo Clinic study to be published in the current edition of Value in Health, Volume 11, Issue 4 and now available as an e-publication, offers clinicians the first large-scale contemporary study to help answer the question. The study found no significant difference between the drugs in the length of hospital stay or in the rate of cardiovascular event rates.

“Our results provide data to show using the lower cost drug does not jeopardize patient health in contemporary percutaneous coronary intervention practice,” explains the study's lead author, Kirsten Hall Long, Ph.D. Percutaneous coronary intervention (PCI), also known as angioplasty, is a procedure in which a balloon-tipped catheter is inserted into the narrowed vessel. The balloon is inflated and improves blood flow.

Researchers reviewed records of all Mayo Clinic patients who underwent PCI from November 2000 to August 2004. Of these, 2,123 patients received eptifibatide, and 951 received abciximab.

“It is not likely that there will ever be a randomized clinical trial comparing the two drugs, as it would require over 30,000 patients,” says Henry Ting, M.D., Mayo Clinic cardiologist and co-author. “Our study fills an evidence gap by providing data to help guide treatment decisions.”

Value in Health is a multidisciplinary peer-reviewed journal reporting on evaluations of medical technologies including pharmaceuticals, biologics, devices, procedures and other health care interventions. It provides a scientific forum for communicating health economics and outcomes research methods and findings. The journal is a publication of the International Society for Pharmacoeconomics and Outcomes Research.