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Efficacy of abciximab induced platelet blockade using a rapid point of care assay.

作者信息

Kereiakes D J, Mueller M, Howard W, Lacock P, Anderson L C, Broderick T M, Roth E M, Whang D D, Abbottsmith C W

机构信息

The Carl and Edyth Lindner Research Center for Clinical Cardiovascular Research, Cincinnati, Ohio 45219, USA.

出版信息

J Thromb Thrombolysis. 1999 Jun;7(3):265-76. doi: 10.1023/a:1008931126871.

DOI:10.1023/a:1008931126871
PMID:10375388
Abstract

Anciximab provides potent, but variable degrees of platelet inhibition both during the duration of intravenous administration and at 12 hours following therapy. Platelet function was assessed using the PC-RPFA system in 78 patients scheduled for percutaneous coronary revascularization who were administered the standard abciximab weight-adjusted bolus and 12-hour infusion. The PC-RPFA system is a cartridge-based, semiautomated point-of-care whole-blood assay that incorporates fibrinogen-coated polystyrene beads, buffers, and a modified thrombin receptor activating peptide (Isotrap) in lyophilized form. The instrument detects the agglutination rate between the stimulated platelets and the fibrinogen-coated beads, and provides a quantitative digital display in less than 2 minutes. No differences in the level of platelet inhibition were observed in these abciximab-treated patients by diabetic status, gender, smoking, diagnosis (unstable angina, chronic stable angina, recent myocardial infarction), or abciximab treatment status (first time vs. retreatment). Nocorrelation of the PC-RPFA rate of platelet aggregation with clinical demographic factors was observed, with the exception of baseline hematocrit (r2 = 0.4556). The relationship between the PC-RPFA rate of aggregation and hematocrit reflects light absorbance by erythrocytes and is specific to the PC-RPFA system. The absolute rate of platelet aggregation (slope) reported by the PC-RPFA is correlated with percent aggregation, thus making it potentially possible to predict the level of aggregation without reference to a baseline (pretreatment) measure of platelet function. This correlation was closest for patients having <40% baseline aggregation (r2 = 0.55). Thus, PC-RPFA provides a rapid point-of-care assessment of platelet function that could allow for adjustment of abciximab dosing to achieve targeted levels of platelet inhibition. The utility of this device to optimize therapy with platelet glycoprotein IIb/IIIa inhibitors is currently being evaluated.

摘要

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本文引用的文献

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Circulation. 1999 Feb 9;99(5):620-5. doi: 10.1161/01.cir.99.5.620.
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Pharmacodynamic efficacy, clinical safety, and outcomes after prolonged platelet Glycoprotein IIb/IIIa receptor blockade with oral xemilofiban: results of a multicenter, placebo-controlled, randomized trial.口服 xemilofiban 长期血小板糖蛋白 IIb/IIIa 受体阻滞的药效学疗效、临床安全性及结果:一项多中心、安慰剂对照、随机试验的结果
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A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina.
阿司匹林联合替罗非班与阿司匹林联合肝素治疗不稳定型心绞痛的比较。
N Engl J Med. 1998 May 21;338(21):1498-505. doi: 10.1056/NEJM199805213382103.
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Pharmacodynamic profile of short-term abciximab treatment demonstrates prolonged platelet inhibition with gradual recovery from GP IIb/IIIa receptor blockade.短期使用阿昔单抗治疗的药效学特征显示,血小板抑制作用持续时间延长,且从糖蛋白IIb/IIIa受体阻滞状态逐渐恢复。
Circulation. 1998 May 5;97(17):1680-8. doi: 10.1161/01.cir.97.17.1680.
5
Randomized trial of an oral platelet glycoprotein IIb/IIIa antagonist, sibrafiban, in patients after an acute coronary syndrome: results of the TIMI 12 trial. Thrombolysis in Myocardial Infarction.急性冠状动脉综合征患者口服血小板糖蛋白IIb/IIIa拮抗剂西拉非班的随机试验:心肌梗死溶栓治疗(TIMI)12试验结果
Circulation. 1998 Feb 3;97(4):340-9. doi: 10.1161/01.cir.97.4.340.
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Monitoring platelet GP IIb/IIIa antagonist therapy.监测血小板糖蛋白IIb/IIIa拮抗剂治疗。
Circulation. 1998;97(1):5-9. doi: 10.1161/01.cir.97.1.5.
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Circulation. 1997 Dec 2;96(11):3860-6. doi: 10.1161/01.cir.96.11.3860.
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N Engl J Med. 1997 Jun 12;336(24):1689-96. doi: 10.1056/NEJM199706123362401.