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01-11-2007 | Original article

Inhibition of platelet function by abciximab or high-dose tirofiban in patients with STEMI undergoing primary PCI: a randomised trial

Auteurs: J. W. van Werkum, W. B. M. Gerritsen, J. C. Kelder, C. M. Hackeng, S. M. Ernst, V. H. M. Deneer, M. J. Suttorp, B. J. W. M. Rensing, H. W. M. Plokker, J. M. ten Berg

Gepubliceerd in: Netherlands Heart Journal | Uitgave 11/2007

Abstract

BackgroundIn patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI, few data exist on the magnitude of platelet activation, aggregation and dosing of glycoprotein (GP) IIb/IIIa receptor inhibitors.

Methods Sixty STEMI patients were randomised to abciximab, to high-dose tirofiban or to no additional GP IIb/IIIa inhibitor treatment. Platelet activation (P-selectin expression) was measured using flow cytometry and the level of inhibition of platelet aggregation was assessed using the Plateletworks assay. Additionally, the PFA-100 with the collagen/adenosine-diphosphate cartridge (CADP) was used to compare the levels of platelet inhibition. All measurements were performed at baseline (T₀), immediately after (T₁), 30 minutes (T₂), 60 minutes (T₃) and 120 minutes (T₄) after primary PCI.

Results The level of platelet activation in both GP IIb/IIIa receptor inhibitor treated groups was significantly lower compared with the control group at all time points after primary PCI (p=0.04). Also the administration of the currently recommended dose of abciximab resulted in significantly lower levels of inhibition of aggregation compared with high-dose tirofiban (p<0.0001). In addition, the CADP closure times were significantly prolonged in both GP IIb/IIIa inhibitor treated groups compared with the control group at time points T1 (p=0.006) and T4 (p<0.0001).

Conclusion The administration of high-dose tirofiban resulted in a significantly higher inhibition of platelet aggregation compared with the currently recommended dose of abciximab. Large clinical trials are needed to assess whether this laboratory superiority of high-dose tirofiban translates into higher clinical efficacy. (Neth Heart J 2007;15:375-81.)

vorige artikel Long-term prognostic value of CFVR and FFR versus perfusion scintigraphy in patients with multivessel disease

volgende artikel Stent thrombosis in real-world patients: a comparison of drug-eluting with bare metal stents

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Titel: Inhibition of platelet function by abciximab or high-dose tirofiban in patients with STEMI undergoing primary PCI: a randomised trial
Auteurs: J. W. van Werkum
W. B. M. Gerritsen
J. C. Kelder
C. M. Hackeng
S. M. Ernst
V. H. M. Deneer
M. J. Suttorp
B. J. W. M. Rensing
H. W. M. Plokker
J. M. ten Berg
Publicatiedatum: 01-11-2007
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Netherlands Heart Journal / Uitgave 11/2007
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI: https://doi.org/10.1007/BF03086018

Bohn Stafleu van Loghum

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