Platelet reactivity in comatose survivors of cardiac arrest undergoing percutaneous coronary intervention and hypothermia
| Autor: | Klemen Steblovnik, Marko Noc, Aleš Blinc, Enver Melkic, Igor Kranjec, Mojca Bozic-Mijovski |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Blood Platelets
Male medicine.medical_specialty Acute coronary syndrome Ticlopidine Platelet Aggregation medicine.medical_treatment Eptifibatide Coronary Angiography Cohort Studies Percutaneous Coronary Intervention Hypothermia Induced Internal medicine medicine Humans Platelet Prospective Studies cardiovascular diseases Cardiopulmonary resuscitation Acute Coronary Syndrome Coma Aged Aged 80 and over business.industry Percutaneous coronary intervention Middle Aged Hypothermia Platelet Activation medicine.disease Clopidogrel Cardiopulmonary Resuscitation Case-Control Studies Anesthesia Conventional PCI Cardiology Female Receptors Thrombin medicine.symptom Peptides Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | EuroIntervention. 10:1418-1424 |
| ISSN: | 1774-024X |
| DOI: | 10.4244/eijy14m05_02 |
| Popis: | Aims To investigate the effects of clopidogrel and eptifibatide on platelet reactivity in patients resuscitated from cardiac arrest undergoing percutaneous coronary intervention (PCI) and hypothermia. Methods and results VerifyNow® and Multiplate® aggregometry were used before, and 4, 12, 22 and 48 hours after 600 mg clopidogrel treatment in 28 post-cardiac arrest hypothermic patients and in 14 normothermic patients with acute coronary syndrome. Basal platelet reactivity after stimulation with iso-thrombin receptor-activating peptide (TRAP) and PAR4-activating peptide (BASE) was significantly lower in the post-cardiac arrest group and persisted up to 48 hours. The antiplatelet effect of clopidogrel measured by VerifyNow and expressed as % inhibition was significantly lower in the post-cardiac arrest group. It was close to zero with an increase to only around 10% after 48 hours. Post-cardiac arrest patients receiving eptifibatide showed profound platelet inhibition measured by both VerifyNow IIb/IIIa and Multiplate TRAP tests for at least 22 hours after administration. Conclusions Post-resuscitation syndrome with ongoing hypothermia is associated with decreased platelet reactivity. Clopidogrel loading does not significantly affect platelet function during the first 48 hours. This is in contrast with eptifibatide which produces profound platelet inhibition, and may be used to bridge insufficient inhibition by clopidogrel. |
| Databáze: | OpenAIRE |
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