PMID- 18467322
OWN - NLM
STAT- MEDLINE
DCOM- 20081112
LR  - 20181201
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 29
IP  - 12
DP  - 2008 Jun
TI  - Impact of bivalirudin or unfractionated heparin on platelet aggregation in 
      patients pretreated with 600 mg clopidogrel undergoing elective percutaneous 
      coronary intervention.
PG  - 1504-9
LID - 10.1093/eurheartj/ehn195 [doi]
AB  - AIMS: The aim of this study was to assess the impact of bivalirudin or 
      unfractionated heparin (UFH) on platelet aggregation in patients, pretreated with 
      a 600 mg loading dose clopidogrel, undergoing elective percutaneous coronary 
      intervention (PCI). METHODS AND RESULTS: Patients (n = 100) were recruited 
      consecutively in the setting of a double-blind, randomized trial. Bivalirudin or 
      UFH was administered during PCI. Blood was drawn immediately before PCI, 
      following administration of bivalirudin or UFH directly after PCI, and 24 h after 
      PCI. Adenosine diphosphate (ADP)-induced platelet aggregation was assessed with 
      light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA). 
      Before PCI, ADP-induced platelet aggregation was similar in UFH and bivalirudin 
      patients (P = 0.99 for LTA; P = 0.28 for MEA). Administration of bivalirudin 
      during PCI resulted in significant additional suppression of platelet aggregation 
      (P = 0.012 for LTA; P = 0.008 for MEA). Administration of UFH did not have a 
      significant influence on platelet aggregation (P = 0.42 for LTA; P = 0.78 for 
      MEA). Platelet aggregation was again similar in the two groups 24 h after PCI (P 
      > 0.05 for LTA and MEA). CONCLUSION: Bivalirudin, given during PCI in patients 
      pretreated with 600 mg of clopidogrel, is in contrast to UFH associated with 
      further inhibition of platelet aggregation.
FAU - Sibbing, Dirk
AU  - Sibbing D
AD  - Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar, Technische 
      Universitat Munchen, Munich, Germany.
FAU - Busch, Gabriele
AU  - Busch G
FAU - Braun, Siegmund
AU  - Braun S
FAU - Jawansky, Stefan
AU  - Jawansky S
FAU - Schomig, Albert
AU  - Schomig A
FAU - Kastrati, Adnan
AU  - Kastrati A
FAU - Ott, Ilka
AU  - Ott I
FAU - von Beckerath, Nicolas
AU  - von Beckerath N
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080507
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Recombinant Proteins)
RN  - 61D2G4IYVH (Adenosine Diphosphate)
RN  - 9005-49-6 (Heparin)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Adenosine Diphosphate/metabolism
MH  - Aged
MH  - Angioplasty, Balloon, Coronary
MH  - Anticoagulants/*administration & dosage
MH  - Clopidogrel
MH  - Double-Blind Method
MH  - Female
MH  - Heparin/administration & dosage
MH  - Hirudins/*administration & dosage
MH  - Humans
MH  - Male
MH  - Peptide Fragments/*administration & dosage
MH  - Perioperative Care
MH  - Platelet Aggregation/*drug effects
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Platelet Function Tests/methods
MH  - *Premedication
MH  - Recombinant Proteins/administration & dosage
MH  - Ticlopidine/administration & dosage/analogs & derivatives
EDAT- 2008/05/10 09:00
MHDA- 2008/11/13 09:00
CRDT- 2008/05/10 09:00
PHST- 2008/05/10 09:00 [pubmed]
PHST- 2008/11/13 09:00 [medline]
PHST- 2008/05/10 09:00 [entrez]
AID - ehn195 [pii]
AID - 10.1093/eurheartj/ehn195 [doi]
PST - ppublish
SO  - Eur Heart J. 2008 Jun;29(12):1504-9. doi: 10.1093/eurheartj/ehn195. Epub 2008 May 
      7.