The platelet function dose-response to abciximab during percutaneous coronary revascularization is variable.
The platelet function dose-response to incremental abciximab (Reopro, Eli Lilly/Centocor, Indianapolis, IN) bolus dosing during percutaneous coronary intervention (PCI) was evaluated in 85 patients using a point-of-service platelet function assay. Patients received incremental bolus doses of abciximab at 10- to 20-min intervals; platelet function was measured at 10-min intervals during dosing. The percentage of patients achieving > or = 80% inhibition of platelet function after 50%, 75%, and 100% of a standard abciximab bolus was 40%, 87%, and 95%, respectively. There were no significant associations between the platelet function dose-response to abciximab and age, weight, platelet count, hematocrit, heparin dose, peak activated clotting time, thienopyridine use prior to PCI, gender, cigarette smoking, diabetes mellitus, or clinical syndrome. This study demonstrated significant interpatient variability in platelet function dose-response to abciximab with a substantial proportion (87%) of patients achieving high-level platelet function inhibition with less than the standard abciximab bolus dose.
Casterella
P J
PJ
Division of Cardiovascular Disease, Scripps Clinic, La Jolla, California, USA. pjc151@home.com
Kereiakes
D J
DJ
Steinhubl
S R
SR
Raymond
R E
RE
Kottke-Marchant
K
K
Patel
K
K
Mueller
M
M
Rosenthal
M
M
Moliterno
D J
DJ
Teirstein
P S
PS
D000077284:Abciximab; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D001792:Blood Platelets / Q000187:drug effects*; D023921:Coronary Stenosis / Q000601:surgery; D003402:Creatine Kinase / Q000187:drug effects; D052279:Creatine Kinase, MB Form; D004305:Dose-Response Relationship, Drug; D023381:Endpoint Determination; D005260:Female; D006400:Hematocrit; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007527:Isoenzymes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D015588:Observer Variation; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D007527:Isoenzymes; D010975:Platelet Aggregation Inhibitors; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D000077284:Abciximab