High-dose tirofiban with enoxaparin and inflammatory markers in high-risk percutaneous intervention.

Autor: Walters DL; Cardiology Department, The Prince Charles Hospital Laboratory, Brisbane, Australia. darren_walters@health.qld.gov.au, Ray MJ, Wood P, Perrin EJ, Bett JH, Aroney CN
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2010 Feb; Vol. 40 (2), pp. 139-47. Date of Electronic Publication: 2009 Dec 21.
DOI: 10.1111/j.1365-2362.2009.02237.x
Abstrakt: Aim: The study assessed the benefit of high bolus dose tirofiban (HD-tirofiban) with enoxaparin compared with HD-tirofiban with unfractionated heparin (UFH). The study examined markers of platelet activation, thrombin generation and inflammation.
Materials and Methods: The study is a prospective single centre open-label trial of patients with high-risk acute coronary syndrome treated with percutaneous intervention (PCI) who were randomized to anticoagulation with UFH or enoxaparin with HD-tirofiban (25 microg kg(-1) bolus). This study measured a panel of platelet activation markers, inflammatory biomarkers and thrombus generation between the two groups.
Result: Sixty patients undergoing high-risk PCI were enroled in the study. Platelet inhibition as assessed by whole blood aggregometry following HD-tirofiban infusion was similar in both the UFH and enoxaparin groups. CD40 ligand expression on platelets was significantly reduced following PCI with HD-tirofiban and either UFH or enoxaparin. Following PCI, there were significant reductions measured in other markers of platelet activation including PAC-1, P selectin, factor V/Va, platelet-monocyte aggregates and monocyte expression of Mac-1 as determined by analysis of venous blood samples using flow cytometry. Prothrombin fragment 1+2, D-dimer, von Willebrand factor and high sensitive C-reactive protein levels were significantly less post PCI in the enoxaparin group compared with those patients receiving UFH.
Conclusion: The combination of HD tirofiban with enoxaparin resulted in an attenuated inflammatory response when compared with that of the combination of HD tirofiban with UFH.
Databáze: MEDLINE
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