Switching from abciximab to eptifibatide for percutaneous coronary interventions: a local analysis (SWAP study).
Bibliographic record
Abstract
BACKGROUND: Glycoprotein IIb/IIIa inhibitors (GPI) are recommended as adjunctive therapy with percutaneous coronary interventions (PCI). Before October 2000, abciximab (AB) was the only GPI available at the authors' institution. Eptifibatide (EP) was added to the formulary in October 2000 and became the preferred agent primarily due to lower cost. OBJECTIVES: To describe the impact of switching from AB to EP in the cardiac catheterization laboratory and compare clinical and practice-related outcomes of these agents following PCI. METHODS: Retrospective chart review was performed on patients who received PCI for all indications except as primary therapy for ST-segment elevation myocardial infarction. The AB group consisted of all consecutive patients within the six months preceding formulary addition of EP in October 2000. A matching number of consecutive patients following this date were included in the EP group. RESULTS: A total of 160 patients were included (80 per group). Use of adjunctive GPI increased from 11% to 25% of PCI within three months of adding EP to the formulary (P<0.001). The composite of in-hospital death, myocardial infarction, recurrent ischemia and repeat revascularization occurred in 12.5% of EP- and 2.5% of AB-treated patients (P<0.025). Minor bleeding was more common in the EP group than in the AB group at 8.8% and 2.5%, respectively (not significant). Premature GPI discontinuation was significantly more common in the EP group (46.3% versus 7.5%, P<0.001). The mean +/- SD length of stay post-PCI was 44.4+/-51.2 h for EP and 25.1+/-12.3 h for AB (P<0.0001). CONCLUSIONS: Adjunctive GPI usage more than doubled following the introduction of EP to the formulary. The present results suggest that EP may be associated with inferior clinical outcomes compared with AB for PCI patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".