Unfractionated heparin reduces the anti-platelet effects of abciximab but not eptifibatide during PCI

Clin Appl Thromb Hemost. 2006 Oct;12(4):458-64. doi: 10.1177/1076029606293432.

Abstract

In 29 patients undergoing percutaneous coronary intervention (PCI), we obtained blood samples at baseline, 10 minutes after standard weight-based abciximab (n=15) or double-bolus eptifibatide (n=14) and 5 minutes after unfractionated heparin (UFH; 70 U/kg bolus). The median percent inhibition was significantly higher in the eptifibatide group compared with the abciximab group both before (96.5% [94-100] vs. 85% [77-89.5] [adenosine diphosphate; ADP]; 89.5% [84-95] vs. 59% [37.5-76.5] [thrombin receptor agonist peptide; TRAP], p<0.001 for both) and after UFH (95% [93-100] vs. 79% [68.8-87.5] [ADP]; 82% [77-93] vs. 51% [34.5-71.3] [TRAP], p<0.001 for both). Addition of UFH significantly reduced platelet inhibition in the abciximab group (85% [77-89.5] vs. 79% [68.8-87.5] [ADP]; 59% [37.5-76.5] vs. 51% [34.5-71.3] [TRAP], p<0.05 for both) but not in the eptifibatide group (96.5% [94-100] vs. 95% [93-100] [ADP]; 89.5% [84-95] vs. 82% [77-93] [TRAP], p=ns for both). Eptifibatide achieved superior platelet inhibition before but especially after UFH compared with abciximab.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Abciximab
  • Aged
  • Angioplasty, Balloon, Coronary*
  • Antibodies, Monoclonal / therapeutic use*
  • Anticoagulants / therapeutic use*
  • Blood Coagulation / drug effects
  • Eptifibatide
  • Female
  • Heparin / therapeutic use*
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use*
  • Male
  • Middle Aged
  • Partial Thromboplastin Time
  • Peptides / therapeutic use*
  • Platelet Aggregation / drug effects
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors

Substances

  • Antibodies, Monoclonal
  • Anticoagulants
  • Immunoglobulin Fab Fragments
  • Peptides
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Heparin
  • Eptifibatide
  • Abciximab