Treatment Improves Platelet Function During Stenting
Bivalirudin plus eptifibatide reduces platelet reactivity and clot strength
WEDNESDAY, Feb. 18 (HealthDay News) -- Treatment with bivalirudin plus eptifibatide reduces platelet reactivity and clot strength in patients undergoing elective stenting, which are associated with the risk of myocardial infarction, according to the results of a study published in the Feb. 24 issue of the Journal of the American College of Cardiology.
Paul A. Gurbel, M.D., from the Sinai Center for Thrombosis Research in Baltimore, and colleagues examined platelet reactivity and thrombin-induced platelet-fibrin clot strength (TIP-FCS) in 200 patients undergoing elective stenting who had been randomly assigned to bivalirudin alone or bivalirudin plus eptifibatide. The 128 clopidogrel-naive patients were loaded with 600 mg clopidogrel immediately after stenting while the 72 patients on maintenance clopidogrel therapy continued to receive 75 mg clopidogrel.
The investigators found that the bivalirudin plus eptifibatide group had significantly lower platelet reactivity (as determined by turbidometric aggregometry) and significantly lower mean TIP-FCS (as determined by thrombelastography). This was true regardless of clopidogrel status. Mean 18-hour platelet reactivity and TIP-FCS were significantly higher in patients who had a periprocedural infarction, the researchers report.
"For elective stenting, the addition of eptifibatide to bivalirudin lowered platelet reactivity to multiple agonists and the tensile strength of the TIP-FCS, two measurements strongly associated with periprocedural myonecrosis," Gurbel and colleagues conclude.
The study was supported by a research grant from Integrated Therapeutics Group Inc., a subsidiary of Schering-Plough Corporation. Authors of the study report financial relationships with the pharmaceutical industry.