Effects of coronary prestenting platelet inhibition on coronary poststenting inflammation

J Cardiovasc Pharmacol. 2008 Mar;51(3):286-92. doi: 10.1097/FJC.0b013e318163a90f.

Abstract

The aim of this study was to analyze the effect of 2 antiplatelet regimens on the inhibition of GP IIb/IIIa-dependent platelet activation and their association with the poststenting inflammatory response. Seventeen patients with acute myocardial infarction were divided into 2 groups: (A) clopidogrel plus tirofiban infusion administered together during inclusion (n = 10); (B) clopidogrel administered at inclusion and followed 2 hours after by tirofiban (n = 7). Blood samples were obtained at inclusion and at 24 and 48 hours after stenting. Before stenting, a greater reduction of GP IIb/IIIa-dependent platelet activation was found in both groups, although it was greater in group A than in group B. This statistical difference was not observed at 24 and 48 hours after the procedure. At 48 hours after stenting, interleukin-6, interleukin-10, soluble intracellular adhesion molecule-1, and soluble CD40 ligand plasma values were not different between experimental groups. By proteomics, different isoforms of the following proteins were identified: alpha 1-antitrypsin (ATT-1), fibrinogen gamma chain, apolipoprotein A-IV, apolipoprotein A-I, vitamin D binding protein, haptoglobin, and serotransferrin. At 48 hours after stenting, only the plasma expression of the ATT-1 isoform 5 was significantly increased in group A compared with group B. In conclusion, a greater inhibition of GP IIb/IIIa-dependent platelet activation before stenting was not correlated with a different inflammatory activity early after stenting.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Clopidogrel
  • Drug Administration Schedule
  • Female
  • Humans
  • Inflammation / etiology
  • Inflammation / prevention & control*
  • Infusions, Intravenous
  • Male
  • Myocardial Infarction / therapy
  • Platelet Aggregation / drug effects
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Stents / adverse effects*
  • Ticlopidine / administration & dosage
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / pharmacology
  • Time Factors
  • Tirofiban
  • Tyrosine / administration & dosage
  • Tyrosine / analogs & derivatives*
  • Tyrosine / pharmacology
  • alpha 1-Antitrypsin / drug effects
  • alpha 1-Antitrypsin / metabolism

Substances

  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • alpha 1-Antitrypsin
  • Tyrosine
  • Clopidogrel
  • Tirofiban
  • Ticlopidine