Deng Qiao, Zhang Shichao, Li Mingzhou, Zhang Guozhong, Feng Wenfeng
Southern Medical University, Department of Neurosurgery, Nanfang Hospital, Guangzhou, 510515, China.
J Interv Med. 2020 Aug 16;3(4):174-179. doi: 10.1016/j.jimed.2020.08.005. eCollection 2020 Dec.
To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoprotein IIb/IIIa antagonists (GPI) eptifibatide and tirofiban.
Retrospective analysis of relevant data of patients using GPIs combined with oral antiplatelet therapy in Nanfang Hospital of Southern Medical University from December 2017 to December 2019. The study was approved by the ethics Committee of Nanfang Hospital of Southern Medical University. According to the random use of GPIs drugs, they were assigned to the eptifibatide group and tirofiban group. Basic data, platelet inhibition rates at baseline, 24h and 72h after administration, short-term major adverse cerebrovascular events, and bleeding complications were compared between the two groups.
A total of 47 patients were included in this study, including 24 patients in eptifibatide group and 23 patients in tirofiban group. There was no significant difference in average age (53.75 . 53.91 years) and body mass index (BMI) (24.39 . 22.73 kg/m2) between eptifibatide group and tirofiban group. There was no significant difference in coagulation factor function (R), fibrinogen function (K), fibrinolysis function (EPL), comprehensive coagulation index (Cl), arachidonic acid pathway inhibition rate (AA%) and adenosine diphosphate inhibition rate (ADP%). However, the baseline level of residual platelet function MA (ADP) in eptifibatide group was significantly higher than that in tirofiban group (50.79 . 35.29 mm, P = 0.0026). There was a statistical difference in the platelet aggregation function MA (65.38 . 62.54 mm, p = 0.0442), the rate of spontaneous hemorrhagic stroke (4.3% . 0%) and the rate of asymptomatic minor bleeding (26.08% . 4.1%) in the two groups (P < 0.05).
Both eptifibatide and tirofiban can effectively inhibit platelets, but the effect of etifeptide is better than that of tirofiban in preventing intracranial microhemorrhage and asymptomatic cerebral infarction.
比较使用糖蛋白IIb/IIIa拮抗剂（GPI）依替巴肽和替罗非班治疗颅内动脉瘤的Pipeline的抗血小板效果及主要不良脑血管事件。
回顾性分析2017年12月至2019年12月在南方医科大学南方医院使用GPI联合口服抗血小板治疗的患者的相关数据。该研究经南方医科大学南方医院伦理委员会批准。根据GPI药物的随机使用情况，将患者分为依替巴肽组和替罗非班组。比较两组的基本数据、给药前、给药后24小时和72小时的血小板抑制率、短期主要不良脑血管事件及出血并发症。
本研究共纳入47例患者，其中依替巴肽组24例，替罗非班组23例。依替巴肽组和替罗非班组的平均年龄（53.75. 53.91岁）和体重指数（BMI）（24.39. 22.73 kg/m2）无显著差异。凝血因子功能（R）、纤维蛋白原功能（K）、纤溶功能（EPL）、综合凝血指数（Cl）、花生四烯酸途径抑制率（AA%）和二磷酸腺苷抑制率（ADP%）无显著差异。然而，依替巴肽组残余血小板功能MA（ADP）的基线水平显著高于替罗非班组（50.79. 35.29 mm，P = 0.0026）。两组的血小板聚集功能MA（65.38. 62.54 mm，p = 0.0442）、自发性出血性卒中发生率（4.3%. 0%）和无症状轻微出血发生率（26.08%. 4.1%）存在统计学差异（P < 0.05）。
依替巴肽和替罗非班均能有效抑制血小板，但依替巴肽在预防颅内微出血和无症状性脑梗死方面的效果优于替罗非班。
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