Unfractionated heparin reduces the anti-platelet effects of abciximab but not eptifibatide during PCI

EN Deliargyris, B Upadhya, LG Melton… - Clinical and applied …, 2006 - journals.sagepub.com
EN Deliargyris, B Upadhya, LG Melton, C Thompson, M Fisher, DA Gabriel, GJ Dehmer…
Clinical and applied thrombosis/hemostasis, 2006journals.sagepub.com
In 29 patients undergoing percutaneous coronary intervention (PCI), we obtained blood
samples at baseline, 10 minutes after standard weight-based abciximab (n= 15) or double-
bolus eptifibatide (n= 14) and 5 minutes after unfractionated heparin (UFH; 70 U/kg bolus).
The median percent inhibition was significantly higher in the eptifibatide group compared
with the abciximab group both before (96.5%[94-100] vs. 85%[77-89.5][adenosine
diphosphate; ADP]; 89.5%[84-95] vs. 59%[37.5-76.5][thrombin receptor agonist peptide; …
In 29 patients undergoing percutaneous coronary intervention (PCI), we obtained blood samples at baseline, 10 minutes after standard weight-based abciximab (n=15) or double-bolus eptifibatide (n=14) and 5 minutes after unfractionated heparin (UFH; 70 U/kg bolus). The median percent inhibition was significantly higher in the eptifibatide group compared with the abciximab group both before (96.5% [94-100] vs. 85% [77-89.5] [adenosine diphosphate; ADP]; 89.5% [84-95] vs. 59% [37.5-76.5] [thrombin receptor agonist peptide; TRAP], p<0.001 for both) and after UFH (95% [93-100] vs. 79% [68.8-87.5] [ADP]; 82% [77-93] vs. 51% [34.5-71.3] [TRAP], p<0.001 for both). Addition of UFH significantly reduced platelet inhibition in the abciximab group (85% [77-89.5] vs. 79% [68.8-87.5] [ADP]; 59% [37.5-76.5] vs. 51% [34.5-71.3] [TRAP], p<0.05 for both) but not in the eptifibatide group (96.5% [94-100] vs. 95% [93-100] [ADP]; 89.5% [84-95] vs. 82% [77-93] [TRAP], p=ns for both). Eptifibatide achieved superior platelet inhibition before but especially after UFH compared with abciximab.
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