Effects of integrelin, a platelet glycoprotein IIb/IIIa receptor antagonist, in unstable angina - A randomized multicenter trial
| Autor: | Steven J. Mason, Thomas W. Nygaard, Steven P. Schulman, Mark B. Effron, Charles du Mee, Raymond D. Bahr, Gary Gerstenblith, Alan D. Guerci, Eric J. Topol, Patricia Gottdiener, A. Michael Lincoff, John A. Smith, Paul G. Yock, Stephen Raskin, Nisha Chandra, Steven J. Yakubov, Lori Brashears, Frank I. Navetta, Anil Fatterpacker, Pascal J. Goldschmidt-Clermont, Christopher L. Wolfe, Michael M. Kitt, H. Vernon Anderson, James T. Willerson, Paul F. Bray, Robert M. Califf, Robert A. Harrington, James J. Ferguson |
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| Předmět: |
Adult
Male Bleeding Time Platelet Aggregation Fibrinogen receptor Myocardial Infarction Myocardial Ischemia Eptifibatide Hemorrhage Platelet Glycoprotein GPIIb-IIIa Complex Placebo Angina Placebos Bolus (medicine) Sex Factors Double-Blind Method Bleeding time Physiology (medical) Medicine Humans Angina Unstable Prospective Studies Aged Aged 80 and over Aspirin medicine.diagnostic_test Dose-Response Relationship Drug business.industry Unstable angina Heparin Anticoagulants Middle Aged medicine.disease Substance Withdrawal Syndrome Anesthesia Electrocardiography Ambulatory Female Cardiology and Cardiovascular Medicine business Peptides Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | ResearcherID Scopus-Elsevier |
| Popis: | Background Although aspirin is beneficial in patients with unstable angina, it is a relatively weak inhibitor of platelet aggregation. The effect of Integrelin, which inhibits the platelet fibrinogen receptor glycoprotein (GP) IIb/IIIa, on the frequency and duration of Holter ischemia was evaluated in 227 patients with unstable angina. Methods and Results Patients received intravenous heparin and standard anti-ischemic therapy and were randomized to receive oral aspirin and placebo Integrelin; placebo aspirin and low-dose Integrelin, 45 μg/kg bolus followed by a 0.5-μg·kg −1 ·min −1 continuous infusion; or placebo aspirin and high-dose Integrelin, 90 μg/kg bolus followed by a 1.0-μg·kg −1 ·min −1 constant infusion. Study drug was continued for 24 to 72 hours, and Holter monitoring was performed. Patients randomized to high-dose Integrelin experienced 0.24±0.11 ischemic episodes (mean±SEM) on Holter lasting 8.41±5.29 minutes over 24 hours of study drug infusion. Patients randomized to aspirin experienced a greater number (1.0±0.33, P P =.01) of ischemic episodes than the high-dose Integrelin group. There was no evidence of rebound ischemia after withdrawal of study drug. In 46 patients, platelet aggregation was rapidly inhibited by Integrelin in a dose-dependent fashion. The number of clinical events was small, and there were no bleeding differences in the three treatment arms. Conclusions Intravenous Integrelin is well tolerated, is a potent reversible inhibitor of platelet aggregation, and added to full-dose heparin reduces the number and duration of Holter ischemic events in patients with unstable angina compared with aspirin. |
| Databáze: | OpenAIRE |
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