PDF herunterladen
Dtsch Med Wochenschr 2003; 128(6): 281-287
DOI: 10.1055/s-2003-37078
Übersichten
© Georg Thieme Verlag Stuttgart · New York

Bedeutung von GP IIb/IIIa-Rezeptor-Antagonisten in der invasiven Kardiologie

Impact of GP IIb/IIIa antagonists in interventional cardiologyB. Scheller1 , B. Hennen1 , M. Böhm1 , G. Nickenig1
  • 1Innere Medizin III, Kardiologie/Angiologie, (Direktor: Prof. Dr. M. Böhm), Universität des Saarlandes, Homburg/Saar
Weitere Informationen

Publikationsverlauf

eingereicht: 6.5.2002

akzeptiert: 22.9.2002

Publikationsdatum:
06. Februar 2003 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Neben der ursprünglichen atherosklerotischen Gefäßwandläsion spielen Thrombozyten bei der Atherogenese, aber insbesondere beim akuten Koronarsyndrom (ACS) eine zentrale Rolle [18]. GP IIb/IIIa-Antagonisten hemmen die gemeinsame Endstrecke in der Thrombozytenaggregation. Eine Vielzahl von Untersuchungen zeigen eine Reduktion kardialer Ereignisse durch GP IIb/IIIa-Antagonisten. Aufgrund des unterschiedlichen Studienaufbaus und der unterschiedlichen untersuchten Patientengruppen besteht eine Restunsicherheit zu der Frage, zu welchem Zeitpunkt und in welcher definierten klinischen Situation ein GP IIb/IIIa-Antagonist verabreicht werden sollte.

Literatur

  • 1 Antman E, Giugliano R, Gibson C. et al . Abciximab Facilitates the Rate and Extent of Thrombolysis. Results of the Thrombolysis In Myocardial Infarction (TIMI) 14 Trial.  Circulation. 1999;  99 2720-2732
    Suche in Google Scholar
  • 2 Antman E, Louwerenburg H, Baars H. et al. for the ENTIRE-TIMI 23 Investigators . Enoxaparin as Adjunctive Antithrombin Therapy for ST-Elevation Myocardial Infarction Results of the ENTIRE-Thrombolysis in Myocardial Infarction (TIMI) 23 Trial.  Circulation. 2002;  105 r27-r34
    Suche in Google Scholar
  • 3 Berkowitz S D, Harrington R A, Rund M M, Tcheng J E. Acute profound thrombocytopenia after C7E3 Fab (abciximab) therapy.  Circulation. 1997;  95 809-813
    Suche in Google Scholar
  • 4 Bertrand M E. et al . Management of acute coronary syndromes: acute coronary syndromes without persistent ST segment elevation.  Eur Heart J. 2000;  21 1406-1432
    Suche in Google Scholar
  • 5 Bhatt D L, Marso S P. et al . Abciximab reduces mortality in diabetics following percutaneous coronary intervention.  J Am Coll Cardiol. 2000;  35 922-928
    Suche in Google Scholar
  • 6 Boersma E. et al . Platelet glycoprotein IIb/IIIa-receptor inhibition in non-ST-elevation acute coronary syndromes.  Circulation. 1999;  100 2045-2048
    Suche in Google Scholar
  • 7 Boersma E, Harrington R A, Moliterno D J. et al . Platelet glycoprotein IIb/IIIa-inhibitors in acute coronary syndromes.  Lancet. 2002;  359 189-198
    Suche in Google Scholar
  • 8 Brener S J, Barr L A, Burchenal J E. et al . Randomized, Plazebo-controlled trial of platelet glycoprotein IIb/IIIa-blockade with primary angioplasty for acute myocardial infarction. ReoPro and Primary PTCA Organization and Randomized Trial (RAPPORT) Investigators.  Circulation. 1998;  98 734-741
    Suche in Google Scholar
  • 9 Cannon C P. et al . Randomized trial of an oral platelet glycoprotein IIb/IIIa-antagonist, sibrafiban, in patients after an acute coronary syndrome: results of the TIMI 12 trial. Thrombolysis in Myocardial Infarction.  Circulation. 1998;  97 340-349
    Suche in Google Scholar
  • 10 Cannon C P, McCabe C H, Wilcox R G. et al . Oral glycoprotein IIb/IIIa-inhibition with orbofiban in patients with unstable coronary syndromes (OPUS-TIMI 16) trial.  Circulation. 2000;  102 149-156
    Suche in Google Scholar
  • 11 Cannon C P, Weintraub W S. et al . Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa-inhibitor tirofiban.  N Engl J Med. 2001;  344 1879-1887
    Suche in Google Scholar
  • 12 Chew D P, Bhatt D L, Sapp S, Topol E. Increased mortality with oral platelet glycoprotein IIb/IIIa-antagonists. A meta-analysis of phase III multicenter randomised trials.  Circulation. 2001;  103 201-206
    Suche in Google Scholar
  • 13 Coller B S, Peerschke E I, Scudder L E, Sullivan C A. A murine monoclonal antibody that completely blocks the binding of fibrinogen to platelets produces a thrombasthenic-like state in normal platelets and binds to glycoproteins IIb and/or IIIa.  J Clin Invest. 1983;  72 325-338
    Suche in Google Scholar
  • 14 Collet J P, Montalescot G, Lesty C. et al . Effects of Abciximab on the Architecture of Platelet-Rich Clots in Patients With Acute Myocardial Infarction Undergoing Primary Coronary Intervention.  Circulation. 2001;  103 2328-2331
    Suche in Google Scholar
  • 15 Combining thrombolysis with the platelet glycoprotein IIb/IIIa-inhibitor lamifiban . results of the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) trial.  J Am Coll Cardiol. 1998;  32 2003-2010
    Suche in Google Scholar
  • 16 Comparative 30-day economic and clinical outcomes of platelet glycoprotein IIb/IIIa-inhibitor use during elective percutaneous coronary intervention . Prairie ReoPro versus Integrilin Cost Evaluation (PRICE) Trial.  Am Heart J. 2000;  141 402-9
    Suche in Google Scholar
  • 17 Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin . the ASSENT-3 randomised trial in acute myocardial infarction.  Lancet. 2001;  358 605-613
    Suche in Google Scholar
  • 18 Fuster V, Badimon L. et al . The pathogenesis of coronary artery disease and the acute coronary syndromes (1).   N Engl J Med. 1992;  326 242-250
    Suche in Google Scholar
  • 19 Gawaz M, Neumann F J, Schomig A. Evaluation of platelet membrane glycoproteins in coronary artery disease.  Circulation. 1999;  99 E1-E11
    Suche in Google Scholar
  • 20 Gibson C M, Goel M, Cohen D J. et al . Six-month angiographic and clinical follow-up of patients prospectively randomized to receive either tirofiban or Plazebo during angioplasty in the RESTORE trial. Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis.  J Am Coll Cardiol. 1998;  32 28-34
    Suche in Google Scholar
  • 21 Grines C L, Cox D A, Stone G W. et al . Coronary angioplasty with or without stent implantation for acute myocardial infarction. Stent Primary Angioplasty in Myocardial Infarction Study Group.  N Engl J Med. 1999;  341 1949-56
    Suche in Google Scholar
  • 22 Harrington R A, Armstrong P W. et al . Dose-finding, safety, and tolerability study of an oral platelet glycoprotein IIb/IIIa-inhibitor, lotrafiban, in patients with coronary or cerebral atherosclerotic disease.  Circulation. 2000;  102 728-735
    Suche in Google Scholar
  • 23 Hofmann R, Kerschner K, Steinwender C, Kypta A, Bibl D, Leisch F. Abciximab bolus injection does not reduce cerebral ischemic complications of elective carotid artery stenting: a randomized study.  Stroke. 2002;  33 725-727
    Suche in Google Scholar
  • 24 IMPACT Investigators . Randomised Plazebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention: IMPACT-II. Integrilin to Minimise Platelet Aggregation and Coronary Thrombosis-II.  Lancet. 1997;  349 1422-1428
    Suche in Google Scholar
  • 25 Inhibition of platelet glycoprotein IIb/IIIa-with eptifibatide in patients with acute coronary syndromes . The PURSUIT Trial Investigators. Platelet Glycoprotein IIb/IIIa-in Unstable Angina: Receptor Suppression Using Integrilin Therapy.  N Engl J Med. 1998;  339 436-443
    Suche in Google Scholar
  • 26 Jong P, Cohen E A, Batchelor W. et al . Bleeding risks with abciximab after full-dose thrombolysis in rescue or urgent angioplasty for acute myocardial infarction.  Am Heart J. 2001;  141 218-225
    Suche in Google Scholar
  • 27 Kereiakes D J, Essell J H, Abbottsmith C W, Broderick T M, Runyon J P. Abciximab-associated profound thrombocytopenia.  Am J Cardiol. 1996;  78 1161-1163
    Suche in Google Scholar
  • 28 Kleiman N S, Ohman E M, Califf R M. et al . Profound inhibition of platelet aggregation with monoclonal antibody 7E3 Fab after thrombolytic therapy. Results of the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) 8 Pilot Study.  J Am Coll Cardiol. 1993;  22 381-389
    Suche in Google Scholar
  • 29 Knight D M. et al . The immunogenicity of the 7E3 murine monoclonal Fab antibody fragment variable region is dramatically reduced in humans by substitution of human for murine constant regions.  Mol Immunol. 1995;  32 1271-1281
    Suche in Google Scholar
  • 30 Lage M J, Barber B L, McCollam P L. et al . Impact of abciximab versus eptifibatide on length of hospital stay for PCI patients.  Cath Card Int. 2001;  53 296-303
    Suche in Google Scholar
  • 31 Lefkovits J, Plow E F, Topol E J. Platelet glycoprotein IIb/IIIa-receptors in cardiovascular medicine.  N Engl J Med. 1995;  332 1553-1559
    Suche in Google Scholar
  • 32 Lincoff A M. et al . Complementary clinical benefits of coronary-artery stenting and blockade of platelet glycoprotein IIb/IIIa-receptors. Evaluation of Platelet IIb/IIIa-Inhibition in Stenting Investigators.  N Engl J Med. 1999;  341 319-327
    Suche in Google Scholar
  • 33 Lincoff A M, Tcheng J E, Califf R M. et al . Sustained suppression of ischemic complications of coronary intervention by platelet GP IIb/IIIa-blockade with abciximab: one-year outcome in the EPILOG trial. Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa-blockade.  Circulation. 1999;  99 1951-1958
    Suche in Google Scholar
  • 34 Lincoff A M, Mark D B, Tcheng J E, Califf R M, Bala M V, Anderson K M, Davidson-Ray L, Knight J D, Cabot C F, Topol E J. et al . Economic assessment of platelet glycoprotein IIb/IIIa-receptor blockade with abciximab and low-dose heparin during percutaneous coronary revascularization: results from the EPILOG randomized trial. Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa-blockade.  Circulation. 2000;  102 2923-2929
    Suche in Google Scholar
  • 35 Marso S P, Lincoff A M, Ellis S G. et al . Optimizing the percutaneous interventional outcomes for patients with diabetes mellitus: results of the EPISTENT (Evaluation of platelet IIb/IIIa-inhibitor for stenting trial) diabetic substudy.  Circulation. 1999;  100 2477-2484
    Suche in Google Scholar
  • 36 Matsuno H. et al . Inhibition of integrin function by a cyclic RGD-containing peptide prevents neointima formation.  Circulation. 1994;  90 2203-2206
    Suche in Google Scholar
  • 37 Mehta S R, Yusuf S, Peters R J. et al . Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study.  Lancet. 2001;  358 527-533
    Suche in Google Scholar
  • 38 McCollam P L, Lage M J, Bala M. A comparison of total hospital costs for percutaneous coronary intervention patients receiving abciximab versus tirofiban.  Catheter Cardiovasc Interv. 2001;  54 152-157
    Suche in Google Scholar
  • 39 Montalescot G. et al . Platelet glycoprotein IIb/IIIa-inhibition with coronary stenting for acute myocardial infarction.  N Engl J Med. 2001;  344 1895-1903
    Suche in Google Scholar
  • 40 Neumann F J. et al . Effect of Glycoprotein IIb/IIIa-Receptor Blockade on Recovery of Coronary Flow and Left Ventricular Function After the Placement of Coronary-Artery Stents in Acute Myocardial Infarction.  Circulation. 1998;  98 2695-2701
    Suche in Google Scholar
  • 41 Neumann F J. et al . Effect of glycoprotein IIb/IIIa-receptor blockade with abciximab on clinical and angiographic restenosis rate after the placement of coronary stents following acute myocardial infarction.  J Am Coll Cardiol. 2000;  35 915-921
    Suche in Google Scholar
  • 42 Newby L K, Ohman E M, Christenson R H. et al . Benefit of glycoprotein IIb/IIIa-inhibition in patients with acute coronary syndromes and troponin t-positive status: the paragon-B troponin T substudy.  Circulation. 2001;  103 2891-2896
    Suche in Google Scholar
  • 43 Ohman E M, Kleiman N S. et al . Combined accelerated tissue-plasminogen activator and platelet glycoprotein IIb/IIIa-integrin receptor blockade with Integrilin in acute myocardial infarction. Results of a randomized, Plazebo-controlled, dose-ranging trial. IMPACT-AMI Investigators.  Circulation. 1997;  95 846-854
    Suche in Google Scholar
  • 44 O’Neill W W, Serruys P, Knudtson M. et al . Long-term treatment with a platelet glycoprotein-receptor antagonist after percutaneous coronary revascularization. EXCITE Trial Investigators. Evaluation of Oral Xemilofiban in Controlling Thrombotic Events.  N Engl J Med. 2000;  342 1316-24
    Suche in Google Scholar
  • 45 O’Shea J C, Hafley G E, Greenberg S. et al . Platelet glycoprotein IIb/IIIa-integrin blockade with eptifibatide in coronary stent intervention: the ESPRIT trial: a randomized controlled trial.  JAMA. 2001;  285 2468-2473
    Suche in Google Scholar
  • 46 PRISM Study Investigators . A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM).  N Engl J Med. 1998;  338 1498-1505
    Suche in Google Scholar
  • 47 PRISM-PLUS Study Investigators . Inhibition of the platelet glycoprotein IIb/IIIa-receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction. Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS).  N Engl J Med. 1998;  338 1488-1497
    Suche in Google Scholar
  • 48 Qureshi A I, Suri M F, Ali Z. et al . Carotid angioplasty and stent placement: a prospective analysis of perioperative complications and impact of intravenously administered abciximab.  Neurosurgery. 2002;  50 466-473
    Suche in Google Scholar
  • 49 Randomised Plazebo-controlled trial of abciximab before and during coronary intervention in refractory unstable angina . the CAPTURE Study.  Lancet. 1997;  349 1429-1435
    Suche in Google Scholar
  • 50 Roffi M, Chew D, Mukherjee D. et al . Platelet Glycoprotein IIb/IIIa Inhibitors Reduce Mortality in Diabetic Patients With Non-ST-Segment-Elevation Acute Coronary Syndromes.  Circulation. 2001;  104 2767-2771
    Suche in Google Scholar
  • 51 Ryan T J. et al . 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction.  Circulation. 1999;  100 1016-1030
    Suche in Google Scholar
  • 52 Shattil S J. Function and regulation of the β3 integrins in hemostasis and vascular biology.  Thromb Haemost. 1995;  74 149-155
    Suche in Google Scholar
  • 53 Simoons M L. Effect of glycoprotein IIb/IIIa-receptor blocker abciximab on outcome in patients with acute coronary syndromes without early coronary revascularisation: the GUSTO IV-ACS randomised trial.  Lancet. 2001;  357 1915-1924
    Suche in Google Scholar
  • 54 Stone G, Grines C, Cox D. et al. for the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Investigators . Comparison of Angioplasty with Stenting, with or without Abciximab, in Acute Myocardial Infarction.  N Engl J Med. 2002;  346 957-966
    Suche in Google Scholar
  • 55 Task Force of the European Society of Cardiology . Management of stable angina pectoris.   Europ Heart J. 1997;  18 394-413
    Suche in Google Scholar
  • 56 Tcheng J E, Ellis S G, George B S. et al . Pharmacodynamics of chimeric glycoprotein IIb/IIIa-integrin antiplatelet antibody Fab 7E3 in high-risk coronary angioplasty.  Circulation. 1994;  90 1757-1764
    Suche in Google Scholar
  • 57 The EPIC Investigators . Us of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa-receptor in high-risk coronary angioplasty.  N Engl J Med. 1994;  330 956-961
    Suche in Google Scholar
  • 58 The EPILOG Investigators . Platelet glycoprotein IIb/IIIa-receptor blockade and low-dose heparin during percutaneous coronary revascularization.  N Engl J Med. 1997;  336 1689-1696
    Suche in Google Scholar
  • 59 The ERASER Investigators . Acute platelet inhibition with abciximab does not reduce in-stent restenosis (ERASER study).  Circulation. 1999;  100 799-806
    Suche in Google Scholar
  • 60 Topol E J, Califf R M, Weisman H F. et al . Randomised trial of coronary intervention with antibody against platelet IIb/IIIa-integrin for reduction of clinical restenosis. results at six months: The EPIC Investigators.  Lancet. 1994;  343 881-886
    Suche in Google Scholar
  • 61 Topol E J, Ferguson J J. et al . Long-term protection from myocardial ischemic events in a randomized trial of brief integrin beta3 blockade with percutaneous coronary intervention. EPIC Investigator Group. Evaluation of Platelet IIb/IIIa-Inhibition for Prevention of Ischemic Complication.  JAMA. 1997;  278 479-484
    Suche in Google Scholar
  • 62 Topol E J, Mark D B. et al . Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa-blockade in patients undergoing coronary stenting. results from a multicentre randomised trial. EPISTENT Investigators: Evaluation of Platelet IIb/IIIa-Inhibitor for Stenting.  Lancet. 1999;  354 2019-2024
    Suche in Google Scholar
  • 63 Topol E J, Yadav J S. Recognition of the importance of embolization in atherosclerotic vascular disease.  Circulation. 2000;  101 570-580
    Suche in Google Scholar
  • 64 Topol E J, Moliterno D J. et al . Comparison of two platelet glycoprotein IIb/IIIa-inhibitors, tirofiban and abciximab, for the prevention of ischemic events with percutaneous coronary revascularization.  N Engl J Med. 2001;  344 1888-1894
    Suche in Google Scholar
  • 65 Topol E J. The GUSTO V Investigators . Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa-inhibition.  Lancet. 2001;  357 1905-1914
    Suche in Google Scholar
  • 66 Trial of abciximab with and without low-dose reteplase for acute myocardial infarction . Strategies for Patency Enhancement in the Emergency Department (SPEED) Group.  Circulation. 2000;  101 2788-2794
    Suche in Google Scholar
  • 67 Turpie A G, Antman E M. Low-molecular-weight heparins in the treatment of acute coronary syndromes.  Arch Intern Med. 2001;  161 1484-1490
    Suche in Google Scholar
  • 68 van den Merkhof L F, Zijlstra F, Olsson H. et al . Abciximab in the treatment of acute myocardial infarction eligible for primary percutaneous transluminal coronary angioplasty. Results of the Glycoprotein Receptor Antagonist Patency Evaluation (GRAPE) pilot study.  J Am Coll Cardiol. 1999;  33 1528-1532
    Suche in Google Scholar
  • 69 Weintraub W S, Culler S. et al . Economic impact of GPIIB/IIIA-blockade after high-risk angioplasty: results from the RESTORE trial. Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis.  J Am Coll Cardiol. 1999;  34 1061-1066
    Suche in Google Scholar
  • 70 Willerson J T, Golino P, Eidt J, Campbell W B, Buja L M. Specific platelet mediators and unstable coronary artery lesions.   Circulation. 1989;  80 198-205
    Suche in Google Scholar
  • 71 Yusuf S, Zhao F, Mehta S R. et al. The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators . Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation.  N Engl J Med. 2001;  345 494-502
    Suche in Google Scholar
  • 72 Zhu M M, Feit A, Chadow H, Alam M, Kwan T, Clark L T. Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta-analysis of randomized clinical trials.  Am J Cardiol. 2001;  88 297-301
    Suche in Google Scholar

Dr. med. Bruno Scheller

Innere Medizin III, Universitätskliniken des Saarlandes

66421 Homburg/Saar

Telefon: +49/6841/1623350

Fax: +49/6841/1623596

eMail: bruno.scheller@uniklinik-saarland.de