GP IIb/IIIa inhibition with eptifibatide lowers levels of soluble CD40L and RANTES after percutaneous coronary intervention

Catheter Cardiovasc Interv. 2004 Feb;61(2):185-9. doi: 10.1002/ccd.10763.

Abstract

Platelets are the most abundant blood source of CD40L, a proinflammatory and prothrombotic costimulatory molecule implicated in atherosclerosis. Agonist stimulation results in the secretion of a soluble form of CD40L (sCD40L) and GP IIb/IIIa receptor inhibition blocks secretion of sCD40L in vitro. However, the effect of GP IIb/IIIa inhibition on sCD40L levels in humans is unknown. Plasma sCD40L and inflammatory markers were measured (t = 0, 0.5, 2, and 24 hr post-PCI) in a cohort of patients receiving abciximab (n = 15), eptifibatide (n = 15), or no GP IIb/IIIa inhibitor (n = 15). PCI in the absence of GP IIb/IIIa inhibitor was associated with a small but measurable rise in sCD40L and the platelet-derived chemokine RANTES. In contrast, eptifibatide significantly lowered baseline sCD40L (P = 0.018) and RANTES (P = 0.006) levels. This effect was not observed with abciximab. GP IIb/IIIa inhibition with eptifibatide lowers levels of sCD40L and RANTES post-stenting, possibly conferring anti-inflammatory as well as antithrombotic effects.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abciximab
  • Aged
  • Analysis of Variance
  • Antibodies, Monoclonal / pharmacology
  • Aspirin / pharmacology
  • CD40 Ligand / blood*
  • Chemokine CCL5 / blood*
  • Coronary Disease / blood*
  • Coronary Disease / surgery*
  • Enzyme-Linked Immunosorbent Assay
  • Eptifibatide
  • Female
  • Heparin / pharmacology
  • Humans
  • Immunoglobulin Fab Fragments / pharmacology
  • Male
  • Middle Aged
  • Peptides / pharmacology*
  • Pilot Projects
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
  • Statistics, Nonparametric
  • Stents*
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Chemokine CCL5
  • Immunoglobulin Fab Fragments
  • Peptides
  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • CD40 Ligand
  • Heparin
  • Eptifibatide
  • Aspirin
  • Abciximab