THE IMPACT OF THREE DIFFERENT GLYCOPROTEIN PLATELET RECEPTOR IIb/IIIa ANTAGONISTS ON GLYCOPROTEIN IIb/IIIa PLATELET RECEPTOR INHIBITION AND CLINICAL ENDPOINTS IN PATIENTS WITH ACUTE CORONARY SYNDROMES

We aim to test patients stratified according to the operators usual practise of planned use or non use of glycoprotein IIb/IIIa antagonists. For those patients in whom the operator would normally choose to use a glycoprotein IIb/IIIa antagonists, patients will be randomized to receive high-dose bolus tirofiban, double bolus eptifibatide or abciximab. Our aim is to compare the effects of downstream high-dose bolus tirofiban, double bolus eptifibatide and abciximab on the degree of glycoprotein IIb/IIIa platelet receptor inhibition, tissue level perfusion and cardiac endpoints in high risk acute coronary syndrome patients treated with percutaneous coronary intervention. Furthermore, patients given ticagrelor and prasugrel versus clopidogrel at the physician's disgression were compared in terms of bleeding events. DOSAGE/DOSAGE FORM, ROUTE, AND DOSE REGIMEN: Where randomized patients will be receive high dose bolus tirofiban (IV loading infusion of tirofiban 25 µg/kg per 3 minutes followed by an infusion of 0.15 µg/kg/min for 12 hours), eptifibatide (IV bolus of 180 µg/kg + second bolus 10 mins after first of 180 µg/kg, simultaneously with first bolus infusion of 2.0 µg/kg/min for 12 hours) or abciximab (0.25mg/kg bolus followed by an infusion of 0.125 µg/kg/min {maximum 10 µg/min} for 12 hours). Initial bolus doses will be administered immediately prior to PCI.