PMID- 20039931
OWN - NLM
STAT- MEDLINE
DCOM- 20100511
LR  - 20181201
IS  - 1365-2362 (Electronic)
IS  - 0014-2972 (Linking)
VI  - 40
IP  - 2
DP  - 2010 Feb
TI  - High-dose tirofiban with enoxaparin and inflammatory markers in high-risk 
      percutaneous intervention.
PG  - 139-47
LID - 10.1111/j.1365-2362.2009.02237.x [doi]
AB  - AIM: The study assessed the benefit of high bolus dose tirofiban (HD-tirofiban) 
      with enoxaparin compared with HD-tirofiban with unfractionated heparin (UFH). The 
      study examined markers of platelet activation, thrombin generation and 
      inflammation. MATERIALS AND METHODS: The study is a prospective single centre 
      open-label trial of patients with high-risk acute coronary syndrome treated with 
      percutaneous intervention (PCI) who were randomized to anticoagulation with UFH 
      or enoxaparin with HD-tirofiban (25 microg kg(-1) bolus). This study measured a 
      panel of platelet activation markers, inflammatory biomarkers and thrombus 
      generation between the two groups. RESULT: Sixty patients undergoing high-risk 
      PCI were enroled in the study. Platelet inhibition as assessed by whole blood 
      aggregometry following HD-tirofiban infusion was similar in both the UFH and 
      enoxaparin groups. CD40 ligand expression on platelets was significantly reduced 
      following PCI with HD-tirofiban and either UFH or enoxaparin. Following PCI, 
      there were significant reductions measured in other markers of platelet 
      activation including PAC-1, P selectin, factor V/Va, platelet-monocyte aggregates 
      and monocyte expression of Mac-1 as determined by analysis of venous blood 
      samples using flow cytometry. Prothrombin fragment 1+2, D-dimer, von Willebrand 
      factor and high sensitive C-reactive protein levels were significantly less post 
      PCI in the enoxaparin group compared with those patients receiving UFH. 
      CONCLUSION: The combination of HD tirofiban with enoxaparin resulted in an 
      attenuated inflammatory response when compared with that of the combination of HD 
      tirofiban with UFH.
FAU - Walters, D L
AU  - Walters DL
AD  - Cardiology Department, The Prince Charles Hospital Laboratory, Brisbane, 
      Australia. darren_walters@health.qld.gov.au
FAU - Ray, M J
AU  - Ray MJ
FAU - Wood, P
AU  - Wood P
FAU - Perrin, E J
AU  - Perrin EJ
FAU - Bett, J H N
AU  - Bett JH
FAU - Aroney, C N
AU  - Aroney CN
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20091221
PL  - England
TA  - Eur J Clin Invest
JT  - European journal of clinical investigation
JID - 0245331
RN  - 0 (Anticoagulants)
RN  - 0 (Biomarkers)
RN  - 0 (Blood Coagulation Factors)
RN  - 0 (Enoxaparin)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 147205-72-9 (CD40 Ligand)
RN  - 42HK56048U (Tyrosine)
RN  - 9005-49-6 (Heparin)
RN  - GGX234SI5H (Tirofiban)
SB  - IM
MH  - Acute Coronary Syndrome/blood/*drug therapy/immunology/therapy
MH  - Aged
MH  - Angioplasty, Balloon
MH  - Anticoagulants/*pharmacology
MH  - Biomarkers/blood
MH  - Blood Coagulation Factors/analysis
MH  - Blood Platelets/immunology
MH  - CD40 Ligand/*metabolism
MH  - Enoxaparin/administration & dosage/*pharmacology
MH  - Female
MH  - Flow Cytometry
MH  - Heparin/administration & dosage/*pharmacology
MH  - Humans
MH  - Inflammation/immunology
MH  - Male
MH  - Middle Aged
MH  - Platelet Activation/*drug effects
MH  - Platelet Aggregation Inhibitors/*pharmacology
MH  - Prospective Studies
MH  - Tirofiban
MH  - Tyrosine/administration & dosage/*analogs & derivatives/pharmacology
EDAT- 2009/12/31 06:00
MHDA- 2010/05/12 06:00
CRDT- 2009/12/31 06:00
PHST- 2009/12/31 06:00 [entrez]
PHST- 2009/12/31 06:00 [pubmed]
PHST- 2010/05/12 06:00 [medline]
AID - ECI2237 [pii]
AID - 10.1111/j.1365-2362.2009.02237.x [doi]
PST - ppublish
SO  - Eur J Clin Invest. 2010 Feb;40(2):139-47. doi: 10.1111/j.1365-2362.2009.02237.x. 
      Epub 2009 Dec 21.