Back to Search
Start Over
Platelet glycoprotein IIb/IIIa receptor blockade and coronary resistance in unstable angina
- Source :
- Journal of the American College of Cardiology. 40(12):2102-2109
- Publication Year :
- 2002
- Publisher :
- Elsevier BV, 2002.
-
Abstract
- ObjectivesWe designed a study to explore the effect of glycoprotein (GP) IIb/IIIa blockade on the atherosclerotic plaque and distal coronary vasculature.BackgroundPlatelet GP IIb/IIIa blockers have been proven to be beneficial in acute ischemic syndromes. This effect has also been attributed to the prevention of microvascular obstruction, although the underlying mechanisms have not been fully defined.MethodsEighteen patients with unstable refractory angina pectoris underwent cardiac catheterization and angioplasty. Trans-stenotic and microvascular resistances to flow were measured at baseline, during hyperventilation, and after intracoronary adenosine. Measurements were repeated early after abciximab administration and after successful percutaneous transluminal coronary angioplasty.ResultsHyperventilation induced an ischemic attack in 12 of 18 patients and increased epicardial (12.8 ± 16.9 vs. 6.1 ± 6.1 mm Hg/ml per min, p < 0.05) and microvascular (9.9 ± 7.5 vs. 6.8 ± 5.8 mm Hg/ml per min, p < 0.05) coronary resistance. Abciximab had no significant effect on epicardial resistance, although it significantly reduced distal coronary resistance under all study conditions, including baseline (4.8 ± 4.8 mm Hg/ml per min, p < 0.01), hyperventilation (5.1 ± 5.4 mm Hg/ml per min, p < 0.01), and intracoronary adenosine (2.7 ± 3.0 vs. 4.3 ± 4.3 mm Hg/ml per min, p < 0.05). The hyperventilation test became negative in all patients after abciximab administration.ConclusionsThese observations confirm the immediate beneficial effects of platelet GP IIb/IIIa blockade with abciximab in acute ischemic syndromes and suggest that improvement of microvascular function may play a central role in the mechanism of action of this drug.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Abciximab
Platelet Glycoprotein GPIIb-IIIa Complex
Immunoglobulin Fab Fragments
Internal medicine
Angioplasty
Coronary Circulation
Hyperventilation
Medicine
Humans
Platelet
Angina, Unstable
Angioplasty, Balloon, Coronary
Cardiac catheterization
Aged
business.industry
Unstable angina
Antibodies, Monoclonal
Middle Aged
medicine.disease
Blockade
medicine.anatomical_structure
Treatment Outcome
Anesthesia
Vascular resistance
Cardiology
Female
Stents
Vascular Resistance
medicine.symptom
business
Cardiology and Cardiovascular Medicine
Blood Flow Velocity
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 40
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....87214d0325c2d8fad3d90da887b9c32a
- Full Text :
- https://doi.org/10.1016/s0735-1097(02)02590-1