Attainment and maintenance of platelet inhibition through standard dosing of abciximab in diabetic and nondiabetic patients undergoing percutaneous coronary intervention.
Attainment and maintenance of platelet inhibition through standard dosing of abciximab in diabetic and nondiabetic patients undergoing percutaneous coronary intervention.
复制标题
在接受经皮冠状动脉介入治疗的糖尿病和非糖尿病患者中，通过标准剂量的阿昔单抗实现和维持血小板抑制。
DOI：
10.1161/01.cir.100.19.1977
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发表时间：
1999
期刊：
影响因子：
37.8
通讯作者：
Lincoff,AM
中科院分区：
文献类型：
--
作者：
Steinhubl,SR;Kottke-Marchant,K;Moliterno,DJ;Rosenthal,ML;Godfrey,NK;Coller,BS;Topol,EJ;Lincoff,AM
背景-尽管阿昔单抗(C7E3 Fab；ReoPro)在接受经皮冠状动脉介入治疗的大量患者中的有效性已在临床试验中得到持续证明，但尚不清楚是否所有患者在治疗期间都达到并保持了靶向抑制。糖尿病患者是已知潜在的血小板异常的患者的一个亚组，他们对阿昔单抗的长期反应已被证明与非糖尿病患者不同。方法和结果-在经皮冠状动脉介入治疗期间接受辅助阿昔单抗治疗的49名糖尿病患者和51名非糖尿病患者进行了前瞻性评估。分别于用药后即刻、用药后8h(用药12h内)、次日早晨(用药后13~26h)用快速血小板功能测定仪(Acumetrics)测定血小板功能抑制程度。阿昔单抗给药后，血小板功能抑制95±4%(平均值±标准差)。8h后，平均抑制率降至88±9%，其中13%的患者抑制率为80%。第二天早晨(平均给药后19小时)，平均抑制率为71±14%。糖尿病患者和非糖尿病患者之间没有发现差异，也没有发现任何生理参数可以预测阿昔单抗的疗效。结论：尽管大多数患者在标准剂量阿昔单抗输注12小时内达到并保持了≥80%的血小板抑制，但患者之间存在很大的差异。糖尿病状态似乎不会影响这种可变性。
Background—Although the effectiveness of abciximab (c7E3 Fab; ReoPro) in large populations of patients undergoing a percutaneous coronary intervention has been consistently proved in clinical trials, it is unknown whether all patients achieve and maintain target inhibition during treatment. Diabetic patients in particular are a subgroup of patients with known underlying platelet abnormalities whose long-term response to abciximab has been shown to vary from that of nondiabetic patients.Methods and Results—Forty-nine diabetic and 51 nondiabetic patients who received adjunctive abciximab therapy during percutaneous coronary interventions were evaluated prospectively. The degree of platelet function inhibition was determined immediately after the abciximab bolus, 8 hours after the bolus (during the 12-hour abciximab infusion), and the next morning (13 to 26 hours after the bolus) with the use of a rapid platelet function assay (Accumetrics). After the abciximab bolus, platelet function was inhibited by 95±4% (mean±SD). By 8 hours, the average percent inhibition had decreased to 88±9%, with 13% of patients with <80% inhibition. The next morning (mean 19 hours after the bolus), mean inhibition was 71±14%. A difference was not found between diabetics and nondiabetics, nor was any physiological parameter found to be predictive of the response to abciximab.Conclusions—Although the majority of patients achieve and maintain ≥80% platelet inhibition during the 12-hour infusion with standard-dose abciximab, there is substantial variability among patients. Diabetic status does not appear to influence this variability.