| The effects of bivalirudin compared with those of unfractionated heparin plus eptifibatide on inflammation and thrombin generation and activity during coronary intervention. | |
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MedLine Citation:
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PMID: 16118546 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To characterize effects of bivalirudin compared with unfractionated heparin plus eptifibatide on inflammation, and thrombin generation and activity after percutaneous coronary intervention. METHODS: We measured the concentration in blood of fibrinopeptide A, prothrombin fragment 1+2, soluble CD40 ligand, interleukin 1 receptor antagonist, interleukin 6, and high sensitivity C-reactive protein in 63 patients treated with aspirin and clopidogrel and undergoing elective percutaneous coronary intervention, who were randomized to treatment with either bivalirudin (n=34) or unfractionated heparin plus eptifibatide (n=29). RESULTS: Neither generation nor activity of thrombin increased 10 min after percutaneous coronary intervention in patients randomized to bivalirudin or unfractionated heparin plus eptifibatide. However, prothrombin fragment 1+2 increased modestly and comparably in both groups after 1 day. Inflammation, reflected by concentrations of interleukin 6 and high sensitivity C-reactive protein in blood, increased similarly 1 day after percutaneous coronary intervention in patients treated with either regimen. In a subset of patients (n=12 in each group) from whom blood was obtained 30 days after percutaneous coronary intervention, the concentration of high sensitivity C-reactive protein was lower in those who had been treated with bivalirudin (by 3.5 mg/l, P=0.002). CONCLUSION: The early effects on inflammation and thrombin generation and activity are similar after treatment with bivalirudin alone compared with unfractionated heparin plus eptifibatide in patients treated with aspirin and clopidogrel who are undergoing percutaneous coronary intervention for symptoms of stable angina. The decreased concentration of high sensitivity C-reactive protein seen 30 days after percutaneous coronary intervention in those treated with bivalirudin is consistent with greater attenuation of inflammation that may have contributed to the trend toward reduced mortality 1 year later in those treated with bivalirudin in REPLACE-2. |
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Authors:
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Friederike K Keating; Harold L Dauerman; Deborah A Whitaker; Burton E Sobel; David J Schneider |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Coronary artery disease Volume: 16 ISSN: 0954-6928 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-08-24 Completed Date: 2006-02-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
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Languages: eng Pagination: 401-5 Citation Subset: IM |
Affiliation:
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Cardiology Unit, Department of Medicine, University of Vermont Burlington, Colchester, Vermont 05446, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Anticoagulants / therapeutic use C-Reactive Protein / metabolism CD40 Ligand / blood Combined Modality Therapy Coronary Artery Disease / blood, therapy* Female Fibrinopeptide A / metabolism Heparin / therapeutic use* Hirudins Humans Interleukin-6 / blood Male Middle Aged Peptide Fragments / metabolism, therapeutic use* Peptides / therapeutic use* Platelet Aggregation Inhibitors / therapeutic use Protein Precursors / metabolism Prothrombin / metabolism Receptors, Interleukin-1 / blood Recombinant Proteins / therapeutic use Thrombin / metabolism* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Hirudins; 0/Interleukin-6; 0/Peptide Fragments; 0/Peptides; 0/Platelet Aggregation Inhibitors; 0/Protein Precursors; 0/Receptors, Interleukin-1; 0/Recombinant Proteins; 0/eptifibatide; 128270-60-0/bivalirudin; 147205-72-9/CD40 Ligand; 25422-31-5/Fibrinopeptide A; 72270-84-9/prothrombin fragment 1; 78768-79-3/prothrombin fragment 2; 9001-26-7/Prothrombin; 9005-49-6/Heparin; 9007-41-4/C-Reactive Protein; EC 3.4.21.5/Thrombin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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