scholarly journals Genetic Polymorphism of CYP2C19 and Inhibitory Effects of Ticagrelor and Clopidogrel Towards Post-Percutaneous Coronary Intervention (PCI) Platelet Aggregation in Patients with Acute Coronary Syndromes

2016 ◽  
Vol 22 ◽  
pp. 4929-4936 ◽  
Author(s):  
Peng Dong ◽  
Xinchun Yang ◽  
Suyan Bian
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Genetic Polymorphism ◽  
Platelet Aggregation ◽  
Acute Coronary Syndromes ◽  
Coronary Intervention ◽  
Inhibitory Effects ◽  
Percutaneous Coronary ◽  
Coronary Syndromes

Tirofiban optimizes platelet inhibition for immediate percutaneous coronary intervention in high-risk acute coronary syndromes

2008 ◽  
Vol 100 (10) ◽  
pp. 648-654 ◽  
Author(s):  
Frieder Keck ◽  
Peter Staritz ◽  
Stephanie Lehrke ◽  
Hugo A. Katus ◽  
Evangelos Giannitsis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Body Weight ◽  
Platelet Aggregation ◽  
Acute Coronary Syndromes ◽  
Coronary Intervention ◽  
Platelet Inhibition ◽  
Percutaneous Coronary ◽  
Coronary Syndromes ◽  
Pre Treatment

SummaryIt was the aim of this study to compare the efficacy of early platelet inhibition by 600 mg clopidogrel and acetylsalicylic acid (ASA) to a triple therapy including a glycoprotein IIb-IIIa receptor blocker. Immediate percutaneous coronary intervention (PCI) is recommended for high-risk acute coronary syndromes. In this setting the efficacy of platelet inhibition is unknown. One hundred patients were randomized to receive ASA and 600 mg clopidogrel, or additional open-label tirofiban (bolus of 10 µg/kg body weight followed by continued infusion of 0.15 µg/kg body weight per minute) as soon as non-ST - segment elevation myocardial infarction was diagnosed. The primary endpoint was the reduction of infarct size determined by post-interventional increases of cardiac troponin T (cTnT). Secondary endpoints included platelet function measured by optical and impedance aggregometry using ADP (5 and 20 µM) and collagen (1 µg/ml) as platelet agonists. Tirofiban maximized platelet inhibition (p<0.0001) immediately and was associated with significantly lower post-interventional cTnT concentrations (p=0.0352). In the dual platelet inhibition arm, clopidogrel was not effective in 69% of patients at the time of coronary intervention, and still in 47%, if pre-treatment time was >120 minutes. The frequency of cardiovascular (death, myocardial infarction, revascularization) and bleeding events was comparable. Platelet aggregation is not adequately inhibited in cTnT - positive patients in the setting of immediate PCI with very short pre-treatment times. Only tirofiban provided consistent and effective inhibition of platelet aggregation at the time of immediate or very early invasive therapy.

Early versus delayed percutaneous coronary intervention in patients with non-ST elevation acute coronary syndromes

2016 ◽  
Vol 27 (5) ◽  
pp. 344-349 ◽  
Author(s):  
Matias B. Yudi ◽  
Andrew E. Ajani ◽  
Nick Andrianopoulos ◽  
Stephen J. Duffy ◽  
Omar Farouque ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndromes ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Coronary Syndromes ◽  
St Elevation
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