The INtegrilin Plus STenting to Avoid Myocardial Necrosis Trial (INSTANT)

Summary

Patients with stable coronary artery disease, undergoing PCI by means of implantation of \>33 mm of DES, will be randomized single-blinded to eptifibatide plus unfractioned heparin according to the ESPRIT protocol vs placebo plus unfractioned heparin.

Timeline

Start

2007-10

Primary completion

2009-10

Completion

2009-10

Outcome

Missed primary endpoint

Stopped: “The study was stopped prematurely due to slow enrolment without code breaking.”

paper Analysis for the primary end point showed a trend toward lower rates of abnormal post-PCI creatine kinase-MB mass values PMID 22607870 ↗

paper the heparin-plus-eptifibatide group (18 [41%]) versus the heparin-alone group (26 [55%], relative risk 0.74 [95% CI 0.48-1.15], P = .169). PMID 22607870 ↗

Publications

• Biondi-Zoccai G, Valgimigli M, Margheri M, Marzocchi A, Lettieri C, Stabile A, Petronio AS, Binetti G, Bolognese L, Bellone P, Sardella G, Contarini M, Sheiban I, Marra S, Piscione F, Romeo F, Colombo A, Sangiorgi G. Assessing the role of eptifibatide in patients with diffuse coronary disease undergoing drug-eluting stenting: the INtegrilin plus STenting to Avoid myocardial Necrosis Trial. Am Heart J. 2012 May;163(5):835.e1-7. doi: 10.1016/j.ahj.2012.02.009.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Eptifibatide	Other / unclassified	2 ug/kg	Intravenous

Indications