Glycoprotein IIB/IIIA inhibitor to reduce postpercutaneous coronary intervention myonecrosis and improve coronary flow in diabetics: the ‘OPTIMIZE-IT’ pilot randomized study

Talarico, Giovanni Paolo; Brancati, Marta Francesca; Burzotta, Francesco; Porto, Italo; Trani, Carlo; Vita, Maria De; Todaro, Daniel; Giammarinaro, Maura; Leone, Antonio Maria; Niccoli, Giampaolo; Andreotti, Felicita; Mazzari, Mario Attilio; Schiavoni, Giovanni; Crea, Filippo

doi:10.2459/jcm.0b013e32832180d9

Cited by 17 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thrombus is the primary cause of graft failure within 1 month after CABG surgery and is also the main threat to stented coronary arteries (28,81). The accumulation of platelets and fibrin on denuded or inflamed endothelium induces acute thrombosis and consequent vSMCs migration and myointimal proliferation (48).…”

Section: Plateletsmentioning

confidence: 99%

“…The activation of platelets cause conformational rearrangements of integrin α IIb β 3 through an outside-in and inside-out signaling process (119,154). Integrin α IIb β 3 antagonists decrease cardiovascular events and stroke and improve the coronary blood flow after PCI procedures (81,(155)(156)(157)(158)(159). However, bleeding complications may limit their use (160,161).…”

Section: Integrinsmentioning

confidence: 99%

See 1 more Smart Citation

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Tseng¹,

Chang²,

Lengquist³

et al. 2015

Thromb Haemost

View full text Add to dashboard Cite

Intimal hyperplasia (IH) is the substrate for accelerated atherosclerosis and limited patency of vein grafts. However, there is still no specific treatment targeting IH following graft surgery. In this study, we used a mouse model of vein grafting to investigate the potential for early intervention with platelet function for later development of graft IH. We transferred the inferior vena cava (IVC) from donor C57BL/6 mice to the carotid artery in recipients using a cuff technique. We found extensive endothelial injury and platelet adhesion one hour following grafting. Adhesion of leukocytes was distinct in areas of platelet adhesion. Platelet and leukocyte adhesion was strongly reduced in mice receiving a function-blocking antibody against the integrin αIIbβ3. This was followed by a reduction of IH one month following grafting. Depletion of platelets using antiserum also reduced IH at later time points. These findings indicate platelets as pivotal to leukocyte recruitment to the wall of vein grafts. In conclusion, the data also highlight early intervention of platelets and inflammation as potential treatment for later formation of IH and accelerated atherosclerosis following bypass surgery.

show abstract

Section: Plateletsmentioning

confidence: 99%

Section: Integrinsmentioning

confidence: 99%

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Tseng¹,

Chang²,

Lengquist³

et al. 2015

Thromb Haemost

View full text Add to dashboard Cite

show abstract

“…Our search identified 22 studies with 10,123 patients (Fig. 1, Table 1) (10,11,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). The studies examined a variety of clinical outcomes, including 7 that used a nonclinical primary outcome (Table 2) (23,24,26,27,30,32,34).…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Glycoprotein IIb/IIIa Inhibitors During Elective Coronary Revascularization

Winchester

Wen

Brearley

et al. 2011

Journal of the American College of Cardiology

View full text Add to dashboard Cite

show abstract

“…The prevalence of raised cTnT levels was similar in the two groups (25 versus 30%, P = 0.56, resp.). Thus, a high-dose bolus of tirofiban in stable diabetic patients undergoing elective PCI was associated with a significant further inhibition of platelet aggregation which, however, did not translate into lower incidence of post-PCI distal embolization [16].…”

Section: Any Advantage From Gp Iib/iiia Antagonism In Diabetics or Himentioning

confidence: 99%

“…There is an undersized study in which 46 stable diabetic patients were enrolled while on double antiplatelet therapy and were either randomized to placebo (N = 22) or to high-dose bolus (25 µg/kg per 3 min) of tirofiban (N = 24) administered immediately before PCI followed by 8 h continuous infusion (0.15 µg/kg per min) [16]. Postprocedural myonecrosis was assessed prospectively by measurement of cardiac troponin T (cTnT) at 6 and 24 h after PCI.…”

Section: Any Advantage From Gp Iib/iiia Antagonism In Diabetics or Himentioning

confidence: 99%

Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes Undergoing PCI: A Long Way to Select Optimal Agent and Route

Puddu

Schiariti

Bugiardini

2011

ISRN Vascular Medicine

View full text Add to dashboard Cite

Antiplatelet treatment in patients with an acute coronary syndrome (ACS), without or with ST segment elevation myocardial infarction (STEMI), forces to keep the balance between potential threats and optimal clinical advantages. Apart from clopidogrel, glycoprotein (GP) IIb/IIIa inhibitors (abciximab and 2 small molecules, tirofiban and eptifibatide) have come to the clinical scene. Recent evidence (2009)(2010)(2011) is reviewed pointing to pharmacoeconometric considerations of concern in times of budget restrictions worldwide. In ACS, when clopidogrel plus aspirin are on, there might be no advantage to add small molecules. Whereas in STEMI patients treated by primary PCI, all 3 GP IIb/IIIa antagonists might be superimposable, when only ACS is present and PCI is elective, definite distinction among the 3 agents, both pharmacoeconomically and pharmacodynamically, might be invoked. There are still points open to debate. Among these the route (upstream versus downstream) is still a matter of uncertainties. Moreover, theoretically, there might be differences not only between abciximab and small molecules (mostly superimposable) but also between tirofiban and eptifibatide (the former being potentially more potent). Thus, a long way is needed before a prominent agent among GPIIb/IIIa inhibitors may be selected. The game is still open, a role will be played soon by new agents.

show abstract

Glycoprotein IIB/IIIA inhibitor to reduce postpercutaneous coronary intervention myonecrosis and improve coronary flow in diabetics: the ‘OPTIMIZE-IT’ pilot randomized study

Abstract: A high-dose bolus of tirofiban in stable diabetic patients undergoing elective PCI, along with double antiplatelet therapy, was associated with a significant further inhibition of platelet aggregation which, however, did not translate in a lower incidence of post-PCI distal embolization.

Cited by 17 publications

References 18 publications

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Efficacy and Safety of Glycoprotein IIb/IIIa Inhibitors During Elective Coronary Revascularization

Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes Undergoing PCI: A Long Way to Select Optimal Agent and Route

Contact Info

Product

Resources

About