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Dr. Grey AI

Peptide

Eptifibatide (Integrilin)

Eptifibatide is a synthetic cyclic heptapeptide GP IIb/IIIa inhibitor that blocks platelet aggregation. FDA-approved 1998 for ACS and PCI. PURSUIT Phase 3 (n=10,948): 1.5% absolute reduction in death/MI/refractory ischemia at 30 days (14.2% vs 15.7%, P=0.04). ESPRIT: 37% relative reduction in death/MI/TVR at 6 months with coronary stenting. High-risk medication per ISMP. SAFETY: Increased bleeding risk (major bleeding 1.3% vs 0.4% in ESPRIT), thrombocytopenia (0.2%).

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
2
Outcomes
7
Graded outcomes
3301

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

Acute Coronary Syndrome (ACS)

Acute Coronary Syndrome (ACS): outcomes studied for Eptifibatide (Integrilin)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Death/MI/Refractory Ischemia

PURSUIT (n=10,948): Composite endpoint 14.2% vs 15.7% placebo at 30 days (P=0.04). 1.5% absolute risk reduction. Benefit apparent by 96 hours. NNT=67 to prevent one event.

Improves (the measure goes down)Small effect21 studies

Studies that measured death/mi/refractory ischemia

and 11 more in the citations list

Major Bleeding

SAFETY CONCERN: ESPRIT: Major bleeding 1.3% vs 0.4% placebo (P=0.027). PURSUIT: 2.1% vs 1.3%. Most bleeding at femoral access sites, mild. No increase in hemorrhagic stroke. ISMP high-risk medication.

Worsens (the measure goes up)Small effect20 studies

Studies that measured major bleeding

and 10 more in the citations list

Thrombocytopenia

SAFETY CONCERN: Significant thrombocytopenia (<20,000/μL) in 0.2% of patients in ESPRIT. Platelet monitoring recommended. Generally reversible upon discontinuation.

Worsens (the measure goes down)Small effect21 studies

Studies that measured thrombocytopenia

and 11 more in the citations list

Percutaneous Coronary Intervention

Percutaneous Coronary Intervention: outcomes studied for Eptifibatide (Integrilin)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Death/MI After PCI Stenting

ESPRIT (n=2,064): Death/MI/TVR 7.5% vs 11.5% at 6 months (HR 0.63, P=0.002). MI reduced at 48h from 9% to 5.4% (P=0.0015). 37% relative risk reduction. Double-bolus regimen.

Improves (the measure goes down)Moderate effect21 studies

Studies that measured death/mi after pci stenting

and 11 more in the citations list

General

General: outcomes studied for Eptifibatide (Integrilin)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Safety/Tolerability

15 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect25 studies

Studies that measured safety/tolerability

and 15 more in the citations list

Cardiac Protection

19 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect23 studies

Studies that measured cardiac protection

and 13 more in the citations list

Blood Pressure

2 human trials support this finding. Human clinical trial data available.

Improves (the measure goes down)Small effect15 studies

Studies that measured blood pressure

and 5 more in the citations list

Key findings

  • Death/MI/Refractory IschemiaAcute Coronary Syndrome (ACS)Improves (the measure goes down)
  • Death/MI After PCI StentingPercutaneous Coronary InterventionImproves (the measure goes down)
  • Major BleedingAcute Coronary Syndrome (ACS)Worsens (the measure goes up)

Safety notes in the studies

  • 1.5% absolute risk reduction.
  • 37% relative risk reduction.
  • ISMP high-risk medication.

Studies cited

48 studies from PubMed

  1. Safety and efficacy of adjunctive tirofiban and eptifibatide in acute ischemic stroke: A systematic review and meta-analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2026 · PMID 41500359
  2. Eptifibatide as an adjuvant therapy to thrombolysis versus thrombolysis alone in stroke management: a systematic review and meta-analysis of randomized controlled trials.Journal of thrombosis and thrombolysis, 2025 · PMID 40544389
  3. A Double-Blinded Randomized Controlled Trial Comparing Eptifibatide Bolus Only Versus Bolus Plus Infusion In Patients Undergoing Primary Percutaneous Coronary Intervention For ST-Elevation Myocardial Infarction.Cardiovascular revascularization medicine : including molecular interventions, 2023 · PMID 36737382
  4. Intracoronary eptifibatide with vasodilators to prevent no-reflow in diabetic STEMI with high thrombus burden. A randomized trial.Revista espanola de cardiologia (English ed.), 2022 · PMID 35039226
  5. Efficacy outcomes and safety measures of intravenous tirofiban or eptifibatide for patients with acute ischemic stroke: a systematic review and meta-analysis of prospective studies.Journal of thrombosis and thrombolysis, 2022 · PMID 34780001
  6. Efficacy and Safety of Abbreviated Eptifibatide Treatment in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.The American journal of cardiology, 2021 · PMID 33065082
  7. Clinical Evaluation of the Tolerability, Pharmacokinetics, and Inhibition of Platelet Aggregation of Eptifibatide in Healthy Chinese Subjects.Clinical pharmacology in drug development, 2020 · PMID 31197974
  8. Antiplatelet agents'-ticagrelol and eptifibatide-safety in experimental colitis in mice.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2020 · PMID 32721916
  9. Thrombocytopenia and Thromboses in Myocardial Infarction Associated with Eptifibatide-Dependent Activating Antiplatelet Antibodies.Thrombosis and haemostasis, 2020 · PMID 32483771
  10. Co-administration of iloprost and eptifibatide in septic shock (CO-ILEPSS)-a randomised, controlled, double-blind investigator-initiated trial investigating safety and efficacy.Critical care (London, England), 2019 · PMID 31488213
  11. Effects of Crushed Ticagrelor Versus Eptifibatide Bolus Plus Clopidogrel in Troponin-Negative Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention: A Randomized Clinical Trial.Journal of the American Heart Association, 2019 · PMID 31766977
  12. Efficacy and safety of eptifibatide versus tirofiban in acute coronary syndrome patients: A systematic review and meta-analysis.Journal of evidence-based medicine, 2017 · PMID 28449419
  13. Is eptifibatide a safe and effective rescue therapy in thromboembolic events complicating cerebral aneurysm coil embolization? Single-center experience in 42 cases and review of the literature.Neuroradiology, 2014 · PMID 24281387
  14. Bleeding risk and safety profile related to the use of eptifibatide: a current reviewExpert Opin Drug Saf, 2012 · PMID 22233272
  15. The kinetics of integrilin limited by obesity: a multicenter randomized pharmacokinetic and pharmacodynamic clinical trial.American heart journal, 2011 · PMID 22137072
  16. Prolonged infusion of eptifibatide as bridge therapy between bare-metal stent insertion and cardiovascular surgery: case report and review of the literature.Pharmacotherapy, 2010 · PMID 20334463
  17. Comparison by meta-analysis of eptifibatide and tirofiban to abciximab in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.The American journal of cardiology, 2010 · PMID 20598998
  18. Safety of eptifibatide for subcortical stroke progression.Cerebrovascular diseases (Basel, Switzerland), 2009 · PMID 19844100
  19. Primary percutaneous coronary angioplasty with and without eptifibatide in ST-segment elevation myocardial infarction: a safety and efficacy study of integrilin-facilitated versus primary percutaneous coronary intervention in ST-segment elevation myocardial infarction (ASSIST).Circulation. Cardiovascular interventions, 2009 · PMID 20031736
  20. EptifibatideExpert Opin Pharmacother, 2008 · PMID 31082110
  21. A review of clinical trials with eptifibatide in cardiology.Cardiovascular drug reviews, 2007 · PMID 18078431
  22. Early initiation of eptifibatide in the emergency department before primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: results of the Time to Integrilin Therapy in Acute Myocardial Infarction (TITAN)-TIMI 34 trial.American heart journal, 2006 · PMID 16996831
  23. Early eptifibatide improves TIMI 3 patency before primary percutaneous coronary intervention for acute ST elevation myocardial infarction: results of the randomized integrilin in acute myocardial infarction (INTAMI) pilot trial.European heart journal, 2005 · PMID 15857851
  24. Administration of intracoronary eptifibatide during ST-elevation myocardial infarction.The American journal of cardiology, 2005 · PMID 16310428
  25. Eptifibatide: a review of its use in patients with acute coronary syndromes and/or undergoing percutaneous coronary intervention.Drugs, 2005 · PMID 16162023
  26. Association between platelet receptor occupancy after eptifibatide (integrilin) therapy and patency, myocardial perfusion, and ST-segment resolution among patients with ST-segment-elevation myocardial infarction: an INTEGRITI (Integrilin and Tenecteplase in Acute Myocardial Infarction) substudy.Circulation, 2004 · PMID 15262838
  27. Combination reperfusion therapy with eptifibatide and reduced-dose tenecteplase for ST-elevation myocardial infarction: results of the integrilin and tenecteplase in acute myocardial infarction (INTEGRITI) Phase II Angiographic Trial.Journal of the American College of Cardiology, 2003 · PMID 12706917
  28. Safety of concomitant therapy with eptifibatide and enoxaparin in patients undergoing percutaneous coronary intervention: results of the Coronary Revascularization Using Integrilin and Single bolus Enoxaparin Study.Journal of the American College of Cardiology, 2003 · PMID 12570939
  29. Eptifibatide-induced acute profound thrombocytopenia presenting as refractory hypotension.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2003 · PMID 12508202
  30. Eptifibatide: a pharmacoeconomic review of its use in percutaneous coronary intervention and acute coronary syndromes.PharmacoEconomics, 2003 · PMID 12908844
  31. Eptifibatide and low-dose tissue plasminogen activator in acute myocardial infarction: the integrilin and low-dose thrombolysis in acute myocardial infarction (INTRO AMI) trial.Journal of the American College of Cardiology, 2002 · PMID 11823073
  32. Platelet glycoprotein IIb/IIIa receptor blockade with integrilin (eptifibatide) for early postinfarction angina in a patient with coronary arterial ectasia.Cardiovascular journal of South Africa : official journal for Southern Africa Cardiac Society [and] South African Society of Cardiac Practitioners, 2002 · PMID 12193965
  33. Eptifibatide in percutaneous coronary intervention. A review.Minerva cardioangiologica, 2002 · PMID 12384635
  34. Platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention: the ESPRIT trial: a randomized controlled trialJAMA, 2001 · PMID 11368699
  35. Attenuation of rebound ischemia after discontinuation of heparin therapy by glycoprotein IIb/IIIa inhibition with eptifibatide in patients with acute coronary syndromes: observations from the platelet IIb/IIIa in unstable angina: receptor suppression using integrilin therapy (PURSUIT) trial.Circulation, 2001 · PMID 11733393
  36. Meta-analysis of effectiveness and safety of abciximab versus eptifibatide or tirofiban in percutaneous coronary intervention.The American journal of cardiology, 2001 · PMID 11230835
  37. Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trialLancet, 2000 · PMID 11145489
  38. Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. PURSUIT InvestigatorsCirculation, 2000 · PMID 10683348
  39. Recurrent ischemia during continuous 12-lead ECG-ischemia monitoring in patients with acute coronary syndromes treated with eptifibatide: relation with death and myocardial infarction. PURSUIT ECG-Ischemia Monitoring Substudy Investigators. Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.Journal of electrocardiology, 2000 · PMID 10819406
  40. Eptifibatide: a review of its use in patients with acute coronary syndromes and/or undergoing percutaneous coronary interventionDrugs, 1999 · PMID 10193692
  41. Clinical outcomes after detection of elevated cardiac enzymes in patients undergoing percutaneous intervention. IMPACT-II Investigators. Integrilin (eptifibatide) to Minimize Platelet Aggregation and Coronary Thrombosis-II.Journal of the American College of Cardiology, 1999 · PMID 9935014
  42. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromesN Engl J Med, 1998 · PMID 9705684
  43. Modifiable risk factors for vascular access site complications in the IMPACT II Trial of angioplasty with versus without eptifibatideJ Am Coll Cardiol, 1998 · PMID 9626829
  44. Randomised placebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention: IMPACT-IILancet, 1997 · PMID 9164315
  45. Design and methodology of the PURSUIT trial: evaluating eptifibatide for acute ischemic coronary syndromesAm Heart J, 1997 · PMID 9291244
  46. Combined accelerated tissue-plasminogen activator and platelet glycoprotein IIb/IIIa integrin receptor blockade with Integrilin in acute myocardial infarction. Results of a randomized, placebo-controlled, dose-ranging trial. IMPACT-AMI Investigators.Circulation, 1997 · PMID 9054741
  47. Primary and secondary safety endpoints from IMPACT II. Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis.The American journal of cardiology, 1997 · PMID 9291243
  48. Impact of eptifibatide on early ischemic events in acute ischemic coronary syndromes: a review of the IMPACT II trial. Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis.The American journal of cardiology, 1997 · PMID 9291242