PMID- 17525363
OWN - NLM
STAT- MEDLINE
DCOM- 20070807
LR  - 20181201
IS  - 1524-4636 (Electronic)
IS  - 1079-5642 (Linking)
VI  - 27
IP  - 8
DP  - 2007 Aug
TI  - Effects of unfractionated heparin and glycoprotein IIb/IIIa antagonists versus 
      bivalirdin on myeloperoxidase release from neutrophils.
PG  - 1850-6
AB  - OBJECTIVES The objective of this study was to determine whether adjunctive 
      therapy during percutaneous coronary intervention (PCI) affects markers of 
      systemic inflammation or platelet activation. Despite different mechanisms of 
      action, direct-thrombin inhibition with bivalirudin during PCI provided similar 
      protection from periprocedural and chronic ischemic complications as compared 
      with unfractionated heparin (UFH) plus planned use of GPIIb/IIIa antagonists in 
      the REPLACE-2 and ACUITY trials. METHODS AND RESULTS: Patients undergoing 
      nonurgent PCI of a native coronary artery were randomized to receive adjunctive 
      therapy with bivalirudin or UFH+eptifibatide. Interleukin (IL)-6 and C-reactive 
      protein (CRP) transiently increased in both groups after PCI. In the 
      UFH+eptifibatide, but not the bivalirudin group, myeloperoxidase (MPO) levels 
      were elevated 2.3-fold above baseline (P=0.004) immediately after PCI. In an in 
      vitro assay, heparin and to a lesser extent enoxaparin, but not bivalirudin or 
      eptifibatide, stimulated MPO release from and binding to neutrophils and 
      neutrophil activation. A mouse model of endoluminal femoral artery denudation was 
      used to investigate further the importance of MPO in the context of arterial 
      injury. CONCLUSIONS: Adjuvant therapy during PCI may have undesired effects on 
      neutrophil activation, MPO release, and systemic inflammation.
FAU - Li, Guohong
AU  - Li G
AD  - Carolina Cardiovascular Biology Center, The University of North Carolina, Chapel 
      Hill, USA.
FAU - Keenan, Alison C
AU  - Keenan AC
FAU - Young, Justin C
AU  - Young JC
FAU - Hall, Margaret J
AU  - Hall MJ
FAU - Pamuklar, Zehra
AU  - Pamuklar Z
FAU - Ohman, E Magnus
AU  - Ohman EM
FAU - Steinhubl, Steven R
AU  - Steinhubl SR
FAU - Smyth, Susan S
AU  - Smyth SS
LA  - eng
GR  - K08 HL070304/HL/NHLBI NIH HHS/United States
GR  - K08HL70304/HL/NHLBI NIH HHS/United States
GR  - R01 HL074219/HL/NHLBI NIH HHS/United States
GR  - R01HL07421/HL/NHLBI NIH HHS/United States
GR  - P01HL080166/HL/NHLBI NIH HHS/United States
GR  - P30DK34987/DK/NIDDK NIH HHS/United States
GR  - P01 HL080166/HL/NHLBI NIH HHS/United States
GR  - RR00046/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20070524
PL  - United States
TA  - Arterioscler Thromb Vasc Biol
JT  - Arteriosclerosis, thrombosis, and vascular biology
JID - 9505803
RN  - 0 (Biomarkers)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Peptides)
RN  - 0 (Recombinant Proteins)
RN  - EC 1.11.1.7 (Peroxidase)
RN  - NA8320J834 (Eptifibatide)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Angioplasty, Balloon, Coronary/methods
MH  - Biomarkers/blood
MH  - Combined Modality Therapy
MH  - Coronary Stenosis/pathology/*therapy
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Eptifibatide
MH  - Female
MH  - Follow-Up Studies
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Hirudins/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neutrophils/cytology
MH  - Peptide Fragments/*administration & dosage
MH  - Peptides/*administration & dosage
MH  - Peroxidase/*metabolism
MH  - Probability
MH  - Recombinant Proteins/administration & dosage
MH  - Reference Values
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2007/05/26 09:00
MHDA- 2007/08/08 09:00
CRDT- 2007/05/26 09:00
PHST- 2007/05/26 09:00 [pubmed]
PHST- 2007/08/08 09:00 [medline]
PHST- 2007/05/26 09:00 [entrez]
AID - ATVBAHA.107.144576 [pii]
AID - 10.1161/ATVBAHA.107.144576 [doi]
PST - ppublish
SO  - Arterioscler Thromb Vasc Biol. 2007 Aug;27(8):1850-6. doi: 
      10.1161/ATVBAHA.107.144576. Epub 2007 May 24.