Effects of platelet glycoprotein IIb/IIIa inhibition with abciximab on thrombin generation and activity during percutaneous coronary intervention.
Effects of platelet glycoprotein IIb/IIIa inhibition with abciximab on thrombin generation and activity during percutaneous coronary intervention.
复制标题
阿昔单抗抑制血小板糖蛋白 IIb/IIIa 对经皮冠状动脉介入治疗期间凝血酶生成和活性的影响。
DOI：
10.1016/s0002-8703(99)70245-0
复制
发表时间：
1999
影响因子：
4.8
通讯作者：
Ambrose,JA
中科院分区：
文献类型：
--
作者：
Dangas,G;Marmur,JD;King,TE;DeLeon,J;Sharma,SK;Vidhun,R;Feldman,D;Stoynov,MY;Badimon,JJ;Ambrose,JA
背景：血小板膜糖蛋白IIb/IIIa拮抗剂可减少经皮冠状动脉介入治疗(PCI)后的急性缺血并发症。阿昔单抗(C7E3 Fab，ReoPro)在体外可减少凝血酶的生成。我们在体内研究了阿昔单抗治疗对凝血酶生成、凝血酶活性和活化凝血时间(ACT)的影响。方法对32例因不稳定冠脉综合征而行经皮冠状动脉介入治疗的患者进行研究。I组(n=11)给予肝素+阿司匹林，II组(n=21)给予肝素+阿司匹林+标准剂量阿昔单抗，在首次肝素滴注后5分钟给药。患者在0时间接受标准肝素注射，并在5分钟、10分钟(仅限ACT)、20分钟和PCI结束时从引导导管获取动脉血标本，检测凝血酶原片段F1.2、纤维蛋白肽A(FPA)和ACT。II组仅给予标准剂量阿昔单抗。每个患者作为他或她自己的对照，比较两组之间相对于基线的变化。结果两组在基线特征、红细胞压积和血小板计数方面无显著差异。与II组比较，I组患者基线时ACT较高，F1.2和FPA较低。FPA和F1.2在II组逐渐下降，F1.2的变化与I组相比有显著差异(II组减少0.59±0.22nmol/L，I组增加0.22±0.3nmol/L，P=0.04)，FPA的变化趋势也是相同的(II组减少1.46±1.16 ng/mL，I组增加2.25±1.58 ng/mL，P=0.07)。ACT对阿昔单抗的反应各不相同，但阿昔单抗给药5分钟后，II组的ACT增加了6.3%(+20秒)，而I组在同一时间点的ACT降低了3.4%(-10秒)(P=.1)。结论阿昔单抗与肝素+阿司匹林联合应用可显著减少凝血酶生成，降低凝血酶活性。(美国心脏杂志1999；138：49-54。)
Background Antagonists of the platelet glycoprotein IIb/IIIa decrease acute ischemic complications after percutaneous coronary interventions (PCI). Abciximab (c7E3 Fab, ReoPro) has been reported to decrease thrombin generation in vitro. We investigated in vivo the effect of abciximab therapy on thrombin generation, thrombin activity, and the activated clotting time (ACT) during PCI. Methods We studied 32 consecutive patients who underwent PCI for unstable coronary syndromes. Group I (n = 11) was treated with heparin plus aspirin, and group II (n = 21) was treated with heparin plus aspirin plus standard-dose abciximab, administered 5 minutes after the initial heparin bolus. Patients received a standardized heparin bolus at time 0, and arterial blood specimens for prothrombin fragment F1.2, fibrinopeptide A (FPA), and ACT were obtained from the guiding catheter at 5 minutes, 10 minutes (ACT only), 20 minutes, and at the end of the PCI. Standard-dose abciximab was administered in group II only. Each patient served as his or her own control, and the changes against the baseline were compared between the 2 groups. Results There were no significant differences between the 2 groups regarding baseline characteristics, hematocrit, and platelet count. Group I patients had higher ACT and lower F1.2 and FPA compared with group II at baseline. Subsequent measurements demonstrated a gradual decrease in FPA and F1.2 in group II; the end of procedure versus baseline changes that occurred in F1.2 were significantly different compared with group I (decrease of 0.59 ± 0.22 nmol/L in group II vs increase of 0.22 ± 0.3 nmol/L in group I, P = .04), and a trend in the same direction was evident for FPA changes (decrease of 1.46 ± 1.16 ng/mL in group II vs increase of 2.25 ± 1.58 ng/mL in group I, P = .07). The ACT response to abciximab was variable, but a 6.3% increase (+20 sec) in ACT was documented 5 minutes after abciximab bolus in group II compared with the 3.4% decrease (–10 sec) observed in group I at the same time point ( P = .1). Conclusion Addition of abciximab to heparin plus aspirin during PCI was associated with a significant decrease in thrombin generation and a borderline decrease in thrombin activity. (Am Heart J 1999;138:49-54.)
登录
查看更多内容
影响因子：
20.3
作者：
KIRCHHOFER, D;TSCHOPP, TB;BAUMGARTNER, HR
通讯作者：
BAUMGARTNER, HR
影响因子：
20.3
作者：
Y. Cadroy;S. Hanson;A. Kelly;U. Marzec;B. Evatt;T. Kunicki;R. Montgomery;L. Harker
通讯作者：
Y. Cadroy;S. Hanson;A. Kelly;U. Marzec;B. Evatt;T. Kunicki;R. Montgomery;L. Harker
新型抗血小板药物：血小板 GPIIb/IIIa 拮抗剂
影响因子：
6.7
作者：
B. Coller;K. Anderson;H. Weisman
通讯作者：
H. Weisman
体内阿司匹林、肝素和抗糖蛋白 IIb-IIIa 单克隆抗体片段在流动条件下对血小板粘附和聚集的实时影响比较。
影响因子：
37.8
作者：
Turner,NA;Moake,JL;Kamat,SG;Schafer,AI;Kleiman,NS;Jordan,R;McIntire,LV
通讯作者：
McIntire,LV
EPIC（评估 7E3 预防缺血性并发症）研究人员的评论和重印，在高风险冠状动脉血管成形术中使用针对血小板糖蛋白 IIb/IIIa 受体的单克隆抗体，新英格兰医学杂志 (1994) 330：956–961
DOI：
10.1016/b978-012448510-5/50164-3
发表时间：
2000
影响因子：
2.3
作者：
M. Lichtman;J. Spivak;L. Boxer;S. Shattil;E. Henderson
通讯作者：
E. Henderson