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Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide.

Publication ,  Journal Article
Batchelor, WB; Tolleson, TR; Huang, Y; Larsen, RL; Mantell, RM; Dillard, P; Davidian, M; Zhang, D; Cantor, WJ; Sketch, MH; Ohman, EM ...
Published in: Circulation
September 17, 2002

BACKGROUND: The relative anti-aggregatory effects of currently prescribed platelet glycoprotein IIb/IIIa receptor antagonists during and after percutaneous coronary intervention for acute coronary syndromes have not been established. METHODS AND RESULTS: We randomized 70 acute coronary syndrome patients undergoing percutaneous coronary intervention to receive abciximab, eptifibatide, or tirofiban at doses used in the Evaluation of Platelet IIb/IIIa Inhibitor for STENTing (EPISTENT), Platelet glycoprotein IIb/IIIa in Unstable angina Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet Receptor Inhibition in ischemic Syndrome Management in Patients Limited by Unstable Signs and symptoms (PRISM-PLUS)/Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis (RESTORE) trials, respectively. Platelet aggregation (PA) in response to 20 micro mol/L of adenosine diphosphate was measured with turbidimetric aggregometry in both D-phenylalanyl-L-prolyl-L-arginine chloromethylketone and citrate-anticoagulated blood early (15 and 30 minutes) and late (4, 12, and 18 to 24 hours) after drug initiation. At 15 and 30 minutes, PA was significantly less inhibited by the tirofiban-RESTORE regimen compared with abciximab (P=0.028) and eptifibatide regimens (P=0.0001). The abciximab regimen, however, showed increasingly varied anti-aggregatory effects during continued infusion for > or =4 hours. Citrate exaggerated ex vivo platelet inhibition after eptifibatide and tirofiban, but had the opposite effect on abciximab. Of all regimens evaluated, the eptifibatide regimen inhibited PA most consistently throughout both the early and late periods. CONCLUSIONS: Currently recommended drug regimens to inhibit the platelet glycoprotein IIb/IIIa receptor have distinct pharmacodynamic profiles that might affect their relative efficacy in acute coronary syndromes and percutaneous coronary intervention.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

September 17, 2002

Volume

106

Issue

12

Start / End Page

1470 / 1476

Location

United States

Related Subject Headings

  • Tyrosine
  • Tirofiban
  • Syndrome
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Platelet Aggregation
  • Peptides
  • Myocardial Infarction
  • Middle Aged
  • Male
 

Citation

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MLA
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Batchelor, W. B., Tolleson, T. R., Huang, Y., Larsen, R. L., Mantell, R. M., Dillard, P., … Harrington, R. A. (2002). Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide. Circulation, 106(12), 1470–1476. https://doi.org/10.1161/01.cir.0000029744.01096.1f
Batchelor, Wayne B., Thaddeus R. Tolleson, Yao Huang, Rhonda L. Larsen, R Michael Mantell, Patricia Dillard, Marie Davidian, et al. “Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide.Circulation 106, no. 12 (September 17, 2002): 1470–76. https://doi.org/10.1161/01.cir.0000029744.01096.1f.
Batchelor WB, Tolleson TR, Huang Y, Larsen RL, Mantell RM, Dillard P, Davidian M, Zhang D, Cantor WJ, Sketch MH, Ohman EM, Zidar JP, Gretler D, DiBattiste PM, Tcheng JE, Califf RM, Harrington RA. Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide. Circulation. 2002 Sep 17;106(12):1470–1476.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

September 17, 2002

Volume

106

Issue

12

Start / End Page

1470 / 1476

Location

United States

Related Subject Headings

  • Tyrosine
  • Tirofiban
  • Syndrome
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Platelet Aggregation
  • Peptides
  • Myocardial Infarction
  • Middle Aged
  • Male