Antiplatelet and anticoagulant agents: Key differences in mechanisms of action, clinical application, and therapeutic benefit in patients with non-ST-segment-elevation acute coronary syndromes

Current Opinion in Cardiology

Volumn 23, Issue 4, 2008, Pages 302-308

  Jennings, Lisa K ^a   Saucedo, Jorge F ^b  

^a UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER   (United States)

^b UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER   (United States)

Author keywords

Acute coronary syndrome; Anticoagulants; Antiplatelet agents; Coronary artery disease; Percutaneous coronary interventions

Indexed keywords

ABCIXIMAB; ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; CLOPIDOGREL; EPTIFIBATIDE; FIBRINOGEN RECEPTOR ANTAGONIST; HEPARIN; HIRULOG; PLACEBO; PRASUGREL; TICLOPIDINE; TIROFIBAN;

ACUTE CORONARY SYNDROME; BLEEDING; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; CORONARY STENT; DRUG MECHANISM; DRUG MEGADOSE; HEART CATHETERIZATION; HEART INFARCTION; HUMAN; ISCHEMIA; KIDNEY FUNCTION; LOADING DRUG DOSE; MEDICAL DECISION MAKING; MONOTHERAPY; PATIENT CARE; PERCUTANEOUS CORONARY INTERVENTION; PRIORITY JOURNAL; REVIEW; ST SEGMENT ELEVATION; THROMBOCYTE AGGREGATION; TREATMENT OUTCOME;

ACUTE CORONARY SYNDROME; ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY; ANTICOAGULANTS; ASPIRIN; HIRUDINS; HUMANS; PEPTIDE FRAGMENTS; PLATELET AGGREGATION INHIBITORS; PLATELET GLYCOPROTEIN GPIIB-IIIA COMPLEX; RECOMBINANT PROTEINS; TICLOPIDINE;

EID: 44649160688     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/HCO.0b013e3283021ad9     Document Type: Review

References (32)

1. Jennings LK, Jacoski MV, White MM. The pharmacodynamics of parenteral glycoprotein IIb/IIIa inhibitors. J Interv Cardiol 2002; 15:45-60.
2. Phillips DR, Charo IF, Parise LV, Fitzgerald LA. The platelet membrane glycoprotein IIb-IIIa complex. Blood 1988; 71:831-843.
3. Lefkovits J, Plow EF, Topol EJ. Platelet glycoprotein IIb/IIIa receptors in cardiovascular medicine. N Engl J Med 1995; 332:1553-1559.
4. Vane JR, Botting RM. The mechanism of action of aspirin. Thromb Res 2003; 110:255-258.
5. Fox KAA, Mehta SR, Peters R, et al. Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in Unstable angina to prevent Recurrent ischemic Events (CURE) Trial. Circulation 2004; 110:1202-1208.
6. The CAPRIE Steering Committee. A randomised, blinded trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996; 348:1329-1339.
7. Gurbel PA, Bliden KP, Hiatt BL, O'Connor CM. Clopidogrel for coronary stenting: response variability, drug resistance, and the effect of pretreatment platelet reactivity. Circulation 2003; 107:2908-2913.
8. Kastrati A, Mehilli J, Neumann FJ, et al. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial. JAMA 2006; 295:1531-1538.
9. Wiviott SD, Braunwald E, McCabe CH, et al., for the TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357:2001-2015. This paper presents important information on prasugrel, a new agent for the treatment of patients with ACS.
10. Kereiakes DJ, Broderick TM, Roth EM, et al. Time course, magnitude, and consistency of platelet inhibition by abciximab, tirofiban, or eptifibatide in patients with unstable angina pectoris undergoing percutaneous coronary intervention. Am J Cardiol 1999; 84:391-395.
11. Steinhubl SR, Kottke-Marchant K, Moliterno DJ, et al. Attainment and maintenance of platelet inhibition through standard dosing of abciximab in diabetic and nondiabetic patients undergoing percutaneous coronary intervention. Circulation 1999; 100:1977-1982.
12. Quinn MJ, Murphy RT, Dooley M, et al. Occupancy of the internal and external pools of glycoprotein IIb/IIIa following abciximab bolus and infusion. J Pharmacol Exp Ther 2001; 297:496-500.
13. Saucedo JF, Lui HK, Garza L, et al. Comparative pharmacodynamic evaluation of eptifibatide and abciximab in patients with non-ST-segment elevation acute coronary syndromes: the TAM2 study. J Thromb Thrombolysis 2004; 18:67-74.
14. Topol EJ, Yadav JS. Recognition of the importance of embolization in atherosclerotic vascular disease. Circulation 2000; 101:570-580.
15. Jordan WD Jr, Voellinger DC, Doblar DD, et al. Microemboli detected by transcranial Doppler monitoring in patients during carotid angioplasty versus carotid endarterectomy. Cardiovasc Surg 1999; 7:33-38.
16. Abdelmeguid AE, Topol EJ, Whitlow PL, et al. Significance of mild transient release of creatine kinase-MB fraction after percutaneous coronary interventions. Circulation 1996; 94:1528-1536.
17. Brener SJ, Lytle BW, Schneider JP, et al. Association between CK-MB elevation after percutaneous or surgical revascularization and three-year mortality. J Am Coll Cardiol 2002; 40:1961-1967.
18. Nallamothu BK, Bates ER. Periprocedural myocardial infarction and mortality: causality versus association. J Am Coll Cardiol 2003; 42:1412-1414.
19. Pasceri V, Patti G, Nusca A, et al. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: results from the ARMYDA (Atorvastatin for Reduction of MYocardial Damage during Angioplasty) study. Circulation 2004; 110:674-678.
20. Saucedo JF, Jehran R, Dangas G, et al. Long-term clinical events following creatine kinase-myocardial band isoenzyme elevation after successful coronary stenting. J Am Coll Cardiol 2000; 35:1134-1141.
21. Gurbel PA, Bliden KP, Zaman KA, et al. Clopidogrel loading with eptifibatide to arrest the reactivity of platelets: results of the Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets (CLEAR PLATELETS) study. Circulation 2005; 111:1153-1159.
22. Boersma E, Harrington RA, Molten DJ, et al. Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomized clinical trials. Lancet 2002; 359:189-198.
23. Karvouni E, Katritsis DG, Ioannidis JPA. Intravenous glycoprotein IIb/IIIa receptor antagonists reduce mortality after percutaneous coronary interventions. J Am Coll Cardiol 2003; 41:26-32.
24. Alexander KP, Chen AY, Roe MT, et al., for the CRUSADE Investigators. Excess dosing of antiplatelet and antithrombin agents in the treatment of non-ST-segment elevation acute coronary syndromes. JAMA 2005; 294:3108-3116.
25. Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol 2007; 50:e1-e157. These updated guidelines are of paramount importance for clinicians treating patients with UA/NSTEMI.
26. Lincoff AM, Bittl JA, Harrington RA, et al. Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial. JAMA 2003; 289:853-863.
27. Stone GW, McLaurin BT, Cox DA, et al., for the ACUITY Investigators. Bivalirudin for patients with acute coronary syndromes. N Engl J Med 2006; 355:2203-2216.
28. Stone GW, White HD, Ohman EM, et al., for the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial investigators. Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial. Lancet 2007; 369:907-919. This paper reports results from a recently completed trial with potential practice-changing implications for patients with NSTEMI ACS undergoing PCI.
29. Stone GW, Bertrand ME, Moses JW, et al., for the ACUITY Investigators. Routine upstream initiation vs deferred selective use of glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: the ACUITY Timing trial. JAMA 2007; 297:591-602. This paper reports important results regarding early vs. deferred selective initiation of GP IIb-IIIa inhibitors.
30. Saucedo JF, Garza L, Wolford DC, et al., Tennessee-Arkansas- Mississippi (TAM) Clinical Research Consortium. Comparative pharmacodynamic evaluation of eptifibatide and tirofiban HCl in patients undergoing percutaneous coronary intervention (the TAM1 Study). Am J Cardiol 2004; 93:1279-1282.
31. Batchelor WB, Tolleson TR, Huang Y, et al. Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Circulation 2002; 106:1470-1476.
32. Saucedo JF, Aude W, Pacheco R, et al. Inhibition of Platelet Aggregation With Eptifibatide, Bivalirudin, and Heparin in Patients Undergoing Percutaneous Coronary Intervention Receiving Clopidogrel Pretreatment (The PharmacoDynamic Evaluation of Angiomax, Clopidogrel with or without INtegrilin [DEACON] Study). Am J Cardiol 2005; 95:1453-1456.