PMID- 15028351
OWN - NLM
STAT- MEDLINE
DCOM- 20040406
LR  - 20191210
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 43
IP  - 6
DP  - 2004 Mar 17
TI  - Administration of eptifibatide to acute coronary syndrome patients receiving 
      enoxaparin or unfractionated heparin: effect on platelet function and thrombus 
      formation.
PG  - 966-71
AB  - OBJECTIVES: The goal of this study was to compare the antithrombotic effects of 
      enoxaparin versus unfractionated heparin (UFH) when combined with eptifibatide in 
      acute coronary syndrome (ACS) patients. BACKGROUND: An increasing number of 
      high-risk ACS patients are treated with low-molecular-weight heparin and a 
      glycoprotein (GP) IIb/IIIa inhibitor. There is a paucity of data regarding the 
      antithrombotic properties of such a combination as compared with UFH and GP 
      IIb/IIIa inhibitors. METHODS: Twenty-six ACS patients scheduled to undergo 
      coronary angiography were treated with subcutaneous enoxaparin (n = 13) or 
      intravenous UFH (n = 13). All patients received eptifibatide just before coronary 
      angiography. Antithrombotic effects were assessed as changes in platelet-thrombus 
      formation using the Badimon ex vivo perfusion chamber. Perfusions were carried 
      out at a high shear rate (HSR) and a low shear rate (LSR). Patients underwent two 
      perfusion studies: at baseline (under enoxaparin or UFH) and 10 min after the 
      eptifibatide bolus. Platelet function was evaluated by ADP-induced platelet 
      aggregation and the rapid platelet function analyzer. RESULTS: Both therapeutic 
      combinations achieved a marked reduction in platelet aggregation after 
      eptifibatide (83% to 89.7% reduction in the enoxaparin-eptifibatide group and 
      77.8% to 85.5% reduction in the UFH-eptifibatide group, inter-group differences 
      not significant). Both groups also demonstrated marked reductions in thrombus 
      formation, but the reductions achieved in the enoxaparin-eptifibatide group were 
      significantly higher than those achieved in the UFH-eptifibatide group (HSR: 
      75.6% reduction vs. 63.9%, respectively, p = 0.01; LSR: 79.7% reduction vs. 
      66.1%, respectively, p = 0.0001). CONCLUSIONS: The combination of eptifibatide 
      with enoxaparin appears to have a more potent antithrombotic effect than that of 
      eptifibatide and UFH in the doses tested.
FAU - Lev, Eli I
AU  - Lev EI
AD  - Cardiology Department, Rabin Medical Center, 39 Jabotinski Street, Petah-Tikva 
      49100, Israel.
FAU - Hasdai, David
AU  - Hasdai D
FAU - Scapa, Erez
AU  - Scapa E
FAU - Tobar, Ana
AU  - Tobar A
FAU - Assali, Abid
AU  - Assali A
FAU - Lahav, Judith
AU  - Lahav J
FAU - Battler, Alexander
AU  - Battler A
FAU - Badimon, Juan J
AU  - Badimon JJ
FAU - Kornowski, Ran
AU  - Kornowski R
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Peptides)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 9005-49-6 (Heparin)
RN  - NA8320J834 (Eptifibatide)
SB  - IM
MH  - Anticoagulants/administration & dosage/pharmacology/*therapeutic use
MH  - Blood Cell Count
MH  - Coronary Angiography
MH  - Drug Therapy, Combination
MH  - Enoxaparin/administration & dosage/pharmacology/*therapeutic use
MH  - Eptifibatide
MH  - Female
MH  - Heparin/administration & dosage/pharmacology/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/*drug therapy/pathology
MH  - Partial Thromboplastin Time
MH  - Peptides/administration & dosage/pharmacology/*therapeutic use
MH  - Platelet Aggregation/drug effects
MH  - Platelet Aggregation Inhibitors/administration & dosage/pharmacology/*therapeutic 
      use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Treatment Outcome
MH  - Venous Thrombosis/prevention & control
EDAT- 2004/03/19 05:00
MHDA- 2004/04/07 05:00
CRDT- 2004/03/19 05:00
PHST- 2003/08/19 00:00 [received]
PHST- 2003/09/16 00:00 [accepted]
PHST- 2004/03/19 05:00 [pubmed]
PHST- 2004/04/07 05:00 [medline]
PHST- 2004/03/19 05:00 [entrez]
AID - S0735109704000191 [pii]
AID - 10.1016/j.jacc.2003.09.060 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2004 Mar 17;43(6):966-71. doi: 10.1016/j.jacc.2003.09.060.