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Clinical and Applied Thrombosis/Hemostasis, Vol. 12, No. 4, 458-464 (2006)
DOI: 10.1177/1076029606293432

Unfractionated Heparin Reduces the Anti-Platelet Effects of Abciximab but not Eptifibatide During PCI

Efthymios N. Deliargyris, MD

Wake Forest University School of Medicine, Winston-Salem, NC

Bharathi Upadhya, MD

Wake Forest University School of Medicine, Winston-Salem, NC

Laura G. Melton, PhD

University of North Carolina School of Medicine, Chapel Hill, NC

Cheryl Thompson, BS

University of North Carolina School of Medicine, Chapel Hill, NC

Melrose Fisher, RN

University of North Carolina School of Medicine, Chapel Hill, NC

Don A. Gabriel, MD, PhD

University of North Carolina School of Medicine, Chapel Hill, NC

Gregory J. Dehmer, MD

Scott & White Clinic, Texas A&M School of Medicine, Temple, TX

David C. Sane, MD

Wake Forest University School of Medicine, Winston-Salem, NC, dsane{at}wfubmc.edu

In 29 patients undergoing percutaneous coronary intervention (PCI), we obtained blood samples at baseline, 10 minutes after standard weight-based abciximab (n=15) or double-bolus eptifibatide (n=14) and 5 minutes after unfractionated heparin (UFH; 70 U/kg bolus). The median percent inhibition was significantly higher in the eptifibatide group compared with the abciximab group both before (96.5% [94-100] vs. 85% [77-89.5] [adenosine diphosphate; ADP]; 89.5% [84-95] vs. 59% [37.5-76.5] [thrombin receptor agonist peptide; TRAP], p<0.001 for both) and after UFH (95% [93-100] vs. 79% [68.8-87.5] [ADP]; 82% [77-93] vs. 51% [34.5-71.3] [TRAP], p<0.001 for both). Addition of UFH significantly reduced platelet inhibition in the abciximab group (85% [77-89.5] vs. 79% [68.8-87.5] [ADP]; 59% [37.5-76.5] vs. 51% [34.5-71.3] [TRAP], p<0.05 for both) but not in the eptifibatide group (96.5% [94-100] vs. 95% [93-100] [ADP]; 89.5% [84-95] vs. 82% [77-93] [TRAP], p=ns for both). Eptifibatide achieved superior platelet inhibition before but especially after UFH compared with abciximab.

Key Words: Heparin • Platelets • Abciximab • Eptifibatide • Platelet aggregation

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