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Immediate and reversible platelet inhibition after intravenous administration of a peptide glycoprotein iib/iiia inhibitor during percutaneous coronary intervention

Academic Article
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Overview

authors

  • Harrington, R. A.
  • Kleiman, N. S.
  • Kottkemarchant, K.
  • Lincoff, A. M.
  • Tcheng, J. E.
  • Sigmon, K. N.
  • Joseph, D.
  • Rios, G.
  • Trainor, K.
  • Rose, D.
  • Greenberg, C. S.
  • Kitt, M. M.
  • Topol, Eric
  • Califf, R. M.

publication date

  • 1995

journal

  • American Journal of Cardiology  Journal

abstract

  • We studied the pharmacokinetic and pharmacodynamic properties of integrelin, a novel platelet glycoprotein IIb/IIIa receptor inhibitor, in patients undergoing elective percutaneous coronary intervention. Patients were randomized to placebo (n = 19) or to 1 of 4 integrelin dosing regimens (total n = 54) that were studied sequentially. All patients received aspirin and heparin. Patients were followed until discharge for the occurrence of adverse clinical events: death, myocardial infarction, coronary artery bypass surgery, repeat intervention, or recurrent ischemia. Bleeding was the primary safety end point. Frequent blood sampling was performed for adenosine diphosphate-induced platelet aggregations. Simplate bleeding times were performed. Adverse clinical events occurred less often in the integrelin-treated patients, although the overall numbers were too small to make a definitive statement as to clinical efficacy. There was no significant increase in serious bleeding among integrelin-treated patients. The 2 highest integrelin boluses (180 and 135 micrograms/kg) immediately (15 minutes after the bolus) provided > 80% inhibition of adenosine diphosphate-induced platelet aggregation in > 75% of treated patients. A constant integrelin infusion of 0.75 micrograms/kg/min maintained this marked antiplatelet effect, whereas an infusion of 0.50 micrograms/kg/min allowed gradual recovery of platelet function. Elective coronary intervention was performed safely and with no significant increase in serious bleeding events using integrelin with aspirin and heparin as an antithrombotic regimen. Integrelin provided rapid, intense, and persistent ex vivo platelet inhibition during coronary intervention. This new antiplatelet agent may be beneficial in reducing platelet-mediated ischemic complications of percutaneous coronary intervention.

subject areas

  • Aged
  • Angioplasty, Balloon, Coronary
  • Aspirin
  • Coronary Disease
  • Double-Blind Method
  • Female
  • Heparin
  • Humans
  • Male
  • Middle Aged
  • Peptides
  • Platelet Aggregation
  • Platelet Aggregation Inhibitors
  • Prospective Studies
  • Single-Blind Method
  • Treatment Outcome
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Identity

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/s0002-9149(99)80345-2

PubMed ID

  • 7503000
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Additional Document Info

start page

  • 1222

end page

  • 1227

volume

  • 76

issue

  • 17

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