In STEMI Complete Reperfusion (TFG 3, TMPG 3, ST Res  70%) is Associated with a Greater Percent of Receptors Occupied by Integrilin 52.0% % Pts With Complete Reperfusion p=0.006 15.4% 13/25 4/22 > 80% Receptors Blocked by Integrilin < 80% Receptors Blocked by Integrilin Gibson CM et al, Circulation 2004

In Vitro Disaggregation Data At 100 times the usual systemic IV dose eptifibatide disaggregates virtually all clot in vitro How could we achieve a concentration 1000 times higher than the IV dose that we currently administer? 100 X IV dose 100 10 X IV dose 90 80 70 60 IV dose 50 Disaggregation Potency (%) 40 30 20 10 0.1875 µg/ml 0.375 µg/ml 3.76 µg/ml Moser M, et al. J Cardiovasc Pharmacol 41:586-592, 2003.

% of GP IIb/IIIa Receptors Occupied IC IV IC IV IC IV IC IV Peripheral Sample Coronary Sinus Sample Peripheral Sample Coronary Sinus Sample Bolus 1 Bolus 2 Diebla data on file

Clot Disaggregation Following IC Eptifibatide: Pre-PCI Angiogram Pinto et al, Am J Cardiol 2006

Retrospective Experience with IC Eptifibatide 59 patients treated with unbuffered IC eptifibatide: TIMI Grade 3 flow in >90% of patients following PCI Normal TIMI myocardial perfusion grade 3 flow (TMPG 3) present in 54.4% of patients following PCI (range 20%-25% in past) There were no in-hospital deaths, reinfarctions, or TIMI major bleeding events No arrhythmias during IC eptifibatide administration Pinto et al, Am J Cardiol 2006

IC TITAN - TIMI 47 IntraCoronary Treatment with Integrilin To Improve ANgiographic Outcomes STEMI for Primary PCI ASA 160-325 mg; Clopidogrel 300-600 mg UFH; IV eptifibatide (double bolus and infusion) Baseline Coronary Angiography Advance wire and balloon without crossing lesion or withdrawing wire IC Eptifibatide 90 μg/kg bolus IC saline bolus 2 min 2 min Angiography of culprit artery to assess stenosis, epicardial flow and myocardial perfusion PCI Angiography of culprit artery to assess epicardial flow and myocardial perfusion