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Therapeutic value of eptifibatide at community hospitals transferring patients to tertiary referral centers early after admission for acute coronary syndromes

Adam B. Greenbaum, MD^*, Robert A. Harrington, MD^*, Michael P. Hudson, MD^*, Cynthia M. MacAulay, MS^*, Robert G. Wilcox, MD, Maarten L. Simoons, MD, FACC, Lisa G. Berdan, PA-C, MHS^*, Alan Guerci, MD, FACC, Dennis V. Cokkinos, MD, FACC^||, Michael M. Kitt, MD^¶, A. Michael Lincoff, MD, FACC^#, Eric J. Topol, MD, FACC^#, Robert M. Califf, MD, FACC^*, E. Magnus Ohman, MD, FACC^* for the PURSUIT Investigators

^* Division of Cardiology, Duke University Medical Center and Duke Clinical Research Institute, Durham, North Carolina, USA
Queen’s Medical Centre, Nottingham, England, UK
Erasmus University, Rotterdam, The Netherlands
St. Francis Hospital, Roslyn, New York, USA
^|| Onassis Cardiac Surgery Center, Athens, Greece
^¶ Cor Therapeutics, San Francisco, California, USA
^# the Cleveland Clinic Foundation, Cleveland, Ohio, USA

View larger version (18K): [in a new window]   Figure 1 Transfer group assignment.

View larger version (21K): [in a new window]   Figure 2 Relation between randomization to eptifibatide and transfer.

View larger version (11K): [in a new window]   Figure 3 Cox proportional odds ratios displaying the relative benefit of eptifibatide as compared with placebo in transfer and nontransfer patients. Squares represent point estimates; lines represent 95% confidence intervals.

View larger version (17K): [in a new window]   Figure 4 Kaplan-Meier plots displaying death or myocardial infarction from randomization to 30 days by treatment assignment between patients transferred during study drug infusion (A) and nontransfer patients (B). Vertical lines represent the 25th, 75th median times to transfer.