1. 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

2. 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
µg/ml
0.375 µg/ml
3.76 µg/ml
Moser M, et al. J Cardiovasc Pharmacol
41: , 2003.

3. % of GP IIb/IIIa Receptors OccupiedIC 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

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

5. 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

6. IC TITAN - TIMI 47 IntraCoronary Treatment with Integrilin To Improve ANgiographic Outcomes
STEMI for Primary PCI
ASA mg; Clopidogrel 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