To compare clinical outcomes and safety of eptifibatide or tirofiban in patients with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI）. Methods：Thirty-six patients with ACS（unstabl...To compare clinical outcomes and safety of eptifibatide or tirofiban in patients with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI）. Methods：Thirty-six patients with ACS（unstable angina/non-ST-segment elevation myocardial infarction, UA/NSTEMI） who underwent PCI were randomly divided into two groups to receive eptifibatide or tirofiban treatment. Eptifibatide or tirofiban was predominantly initiated in the catheter laboratory before the intervention. In-hospital and 30-day MACE outcomes; bleeding as well as platelet counting were investigated in those two groups. Results：No in-hospital and 30-day MACE event occurred in the two groups. The number of ischemia leads after treatment reduced compared to that before PCI in the two groups. There was improvement in the number of ischemia leads for 24 h after administration in the tirofiban group than those in eptifibatide group（4.21 ± 2.46 vs. 3.89 ± 3.31, P =0.03）. The two groups showed no incidence of massive bleeding. Minor bleeding rates were 16.7% and 22.2% in the two groups respectively. Conclusion：Eptifibatide as an adjunct to PCI may further decrease the incidence of ischemia event in patients with ACS and improve the safety, but its long-term efficacy and side effects need further observation.展开更多
GP （glycoprotein） lib/Ilia inhibitors are routinely used in patients with acute coronary syndromes. There have been reported platelet counts of below 20 × 10^9/L within hours of administering the drug. We prese...GP （glycoprotein） lib/Ilia inhibitors are routinely used in patients with acute coronary syndromes. There have been reported platelet counts of below 20 × 10^9/L within hours of administering the drug. We present a case of a 44 years old man with inferior wall myocardial infarction and third-degree heart block who was admitted for cardiac catheterization. The patient successfully underwent percutaneous intervention to right coronary artery and eptifibatide was given per protocol. 6 h post-eptifibatide initiation, platelets dropped from 288 × 10^9/L to 24× 10^9/L. Eptifibatide was stopped and a CBC （complete blood count） was repeated after 2 hours. The platelets had further dropped to undetectable levels showing 0× 10^9/L. The patient remained completely asymptomatic. Pseudo-thrombocytopenia was ruled out on peripheral smear. Platelet transfusion was considered, however, platelets started to rise few hours after stopping of Eptifibatide. Twelve hours later, platelet count reached 4 × 10^9/L. It continued to show a positive trend and reached up to a level of 293× 10^9/L after 5 days. Patient was discharged in a stable condition. Due to this rare but significant phenomenon, patients on these drugs should have their platelet count closely monitored. It is also very rare not to have any symptoms after such critically low platelet levels.展开更多
Objective:To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoproteinⅡb/Ⅲa antagonists(GPI)eptifibatide and tirofiban.Methods:Retrospective a...Objective:To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoproteinⅡb/Ⅲa antagonists(GPI)eptifibatide and tirofiban.Methods:Retrospective analysis of relevant data of patients using GPIs combined with oral antiplatelet therapy in Nanfang Hospital of Southern Medical University from December 2017 to December 2019.The study was approved by the ethics Committee of Nanfang Hospital of Southern Medical University.According to the random use of GPIs drugs,they were assigned to the eptifibatide group and tirofiban group.Basic data,platelet inhibition rates at baseline,24 h and 72 h after administration,short-term major adverse cerebrovascular events,and bleeding complications were compared between the two groups.Results:A total of 47 patients were included in this study,including 24 patients in eptifibatide group and 23 patients in tirofiban group.There was no significant difference in average age(53.75 vs.53.91 years)and body mass index(BMI)(24.39 vs.22.73 kg/m2)between eptifibatide group and tirofiban group.There was no significant difference in coagulation factor function(R),fibrinogen function(K),fibrinolysis function(EPL),comprehensive coagulation index(Cl),arachidonic acid pathway inhibition rate(AA%)and adenosine diphosphate inhibition rate(ADP%).However,the baseline level of residual platelet function MA(ADP)in eptifibatide group was significantly higher than that in tirofiban group(50.79 vs.35.29 mm,P=0.0026).There was a statistical difference in the platelet aggregation function MA(65.38 vs.62.54 mm,p=0.0442),the rate of spontaneous hemorrhagic stroke(4.3%vs.0%)and the rate of asymptomatic minor bleeding(26.08%vs.4.1%)in the two groups(P<0.05).Conclusion:Both eptifibatide and tirofiban can effectively inhibit platelets,but the effect of etifeptide is better than that of tirofiban in preventing intracranial microhemorrhage and asymptomatic cerebral infarction.展开更多
依替巴肽与重组组织型纤溶酶原激活剂（recombinant tissue type plasminogen activator, rtPA）联合溶栓治疗急性缺血性卒中（acute ischemic stroke, AIS）增强方案试验（Combined Approach to Lysis Utilizing Eptifibatide and rtPA...依替巴肽与重组组织型纤溶酶原激活剂（recombinant tissue type plasminogen activator, rtPA）联合溶栓治疗急性缺血性卒中（acute ischemic stroke, AIS）增强方案试验（Combined Approach to Lysis Utilizing Eptifibatide and rtPA in AIS-Enhanced Regimen, CLEAR-ER）证实了rtPA加依替巴肽在AIS患者中的安全性，该研究将AIS患者按5∶1比例随机分组接受0.6 mg/kg rtPA加依替巴肽或标准rtPA（0.9 mg/kg ）溶栓治疗。卒中介入治疗试验（Interventional Management of Stroke, IMS）-Ⅲ是将AIS患者随机分组接受rtPA加血管内治疗或标准rtPA溶栓治疗。白蛋白治疗急性卒中试验-2（Albumin in Acute Stroke Part 2）则是将患者随机分组接受白蛋白±rtPA或生理盐水±rtPA治疗。美国辛辛那提大学神经科学研究所的Adeoye等进行了一项研究，旨在对CLEAR-ER试验联合治疗组患者的转归与后2项试验中倾向得分匹配且仅接受rtPA溶栓治疗的受试者进行比较。展开更多
基金supported by a grant from ShenZhen Hybio Engineering Co.,Ltd.
文摘To compare clinical outcomes and safety of eptifibatide or tirofiban in patients with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI）. Methods：Thirty-six patients with ACS（unstable angina/non-ST-segment elevation myocardial infarction, UA/NSTEMI） who underwent PCI were randomly divided into two groups to receive eptifibatide or tirofiban treatment. Eptifibatide or tirofiban was predominantly initiated in the catheter laboratory before the intervention. In-hospital and 30-day MACE outcomes; bleeding as well as platelet counting were investigated in those two groups. Results：No in-hospital and 30-day MACE event occurred in the two groups. The number of ischemia leads after treatment reduced compared to that before PCI in the two groups. There was improvement in the number of ischemia leads for 24 h after administration in the tirofiban group than those in eptifibatide group（4.21 ± 2.46 vs. 3.89 ± 3.31, P =0.03）. The two groups showed no incidence of massive bleeding. Minor bleeding rates were 16.7% and 22.2% in the two groups respectively. Conclusion：Eptifibatide as an adjunct to PCI may further decrease the incidence of ischemia event in patients with ACS and improve the safety, but its long-term efficacy and side effects need further observation.
文摘GP （glycoprotein） lib/Ilia inhibitors are routinely used in patients with acute coronary syndromes. There have been reported platelet counts of below 20 × 10^9/L within hours of administering the drug. We present a case of a 44 years old man with inferior wall myocardial infarction and third-degree heart block who was admitted for cardiac catheterization. The patient successfully underwent percutaneous intervention to right coronary artery and eptifibatide was given per protocol. 6 h post-eptifibatide initiation, platelets dropped from 288 × 10^9/L to 24× 10^9/L. Eptifibatide was stopped and a CBC （complete blood count） was repeated after 2 hours. The platelets had further dropped to undetectable levels showing 0× 10^9/L. The patient remained completely asymptomatic. Pseudo-thrombocytopenia was ruled out on peripheral smear. Platelet transfusion was considered, however, platelets started to rise few hours after stopping of Eptifibatide. Twelve hours later, platelet count reached 4 × 10^9/L. It continued to show a positive trend and reached up to a level of 293× 10^9/L after 5 days. Patient was discharged in a stable condition. Due to this rare but significant phenomenon, patients on these drugs should have their platelet count closely monitored. It is also very rare not to have any symptoms after such critically low platelet levels.
文摘Objective:To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoproteinⅡb/Ⅲa antagonists(GPI)eptifibatide and tirofiban.Methods:Retrospective analysis of relevant data of patients using GPIs combined with oral antiplatelet therapy in Nanfang Hospital of Southern Medical University from December 2017 to December 2019.The study was approved by the ethics Committee of Nanfang Hospital of Southern Medical University.According to the random use of GPIs drugs,they were assigned to the eptifibatide group and tirofiban group.Basic data,platelet inhibition rates at baseline,24 h and 72 h after administration,short-term major adverse cerebrovascular events,and bleeding complications were compared between the two groups.Results:A total of 47 patients were included in this study,including 24 patients in eptifibatide group and 23 patients in tirofiban group.There was no significant difference in average age(53.75 vs.53.91 years)and body mass index(BMI)(24.39 vs.22.73 kg/m2)between eptifibatide group and tirofiban group.There was no significant difference in coagulation factor function(R),fibrinogen function(K),fibrinolysis function(EPL),comprehensive coagulation index(Cl),arachidonic acid pathway inhibition rate(AA%)and adenosine diphosphate inhibition rate(ADP%).However,the baseline level of residual platelet function MA(ADP)in eptifibatide group was significantly higher than that in tirofiban group(50.79 vs.35.29 mm,P=0.0026).There was a statistical difference in the platelet aggregation function MA(65.38 vs.62.54 mm,p=0.0442),the rate of spontaneous hemorrhagic stroke(4.3%vs.0%)and the rate of asymptomatic minor bleeding(26.08%vs.4.1%)in the two groups(P<0.05).Conclusion:Both eptifibatide and tirofiban can effectively inhibit platelets,but the effect of etifeptide is better than that of tirofiban in preventing intracranial microhemorrhage and asymptomatic cerebral infarction.
文摘依替巴肽与重组组织型纤溶酶原激活剂（recombinant tissue type plasminogen activator, rtPA）联合溶栓治疗急性缺血性卒中（acute ischemic stroke, AIS）增强方案试验（Combined Approach to Lysis Utilizing Eptifibatide and rtPA in AIS-Enhanced Regimen, CLEAR-ER）证实了rtPA加依替巴肽在AIS患者中的安全性，该研究将AIS患者按5∶1比例随机分组接受0.6 mg/kg rtPA加依替巴肽或标准rtPA（0.9 mg/kg ）溶栓治疗。卒中介入治疗试验（Interventional Management of Stroke, IMS）-Ⅲ是将AIS患者随机分组接受rtPA加血管内治疗或标准rtPA溶栓治疗。白蛋白治疗急性卒中试验-2（Albumin in Acute Stroke Part 2）则是将患者随机分组接受白蛋白±rtPA或生理盐水±rtPA治疗。美国辛辛那提大学神经科学研究所的Adeoye等进行了一项研究，旨在对CLEAR-ER试验联合治疗组患者的转归与后2项试验中倾向得分匹配且仅接受rtPA溶栓治疗的受试者进行比较。
