GP IIb/IIIa inhibition with eptifibatide lowers levels of soluble CD40L and RANTES after percutaneous coronary intervention.
Platelets are the most abundant blood source of CD40L, a proinflammatory and prothrombotic costimulatory molecule implicated in atherosclerosis. Agonist stimulation results in the secretion of a soluble form of CD40L (sCD40L) and GP IIb/IIIa receptor inhibition blocks secretion of sCD40L in vitro. However, the effect of GP IIb/IIIa inhibition on sCD40L levels in humans is unknown. Plasma sCD40L and inflammatory markers were measured (t = 0, 0.5, 2, and 24 hr post-PCI) in a cohort of patients receiving abciximab (n = 15), eptifibatide (n = 15), or no GP IIb/IIIa inhibitor (n = 15). PCI in the absence of GP IIb/IIIa inhibitor was associated with a small but measurable rise in sCD40L and the platelet-derived chemokine RANTES. In contrast, eptifibatide significantly lowered baseline sCD40L (P = 0.018) and RANTES (P = 0.006) levels. This effect was not observed with abciximab. GP IIb/IIIa inhibition with eptifibatide lowers levels of sCD40L and RANTES post-stenting, possibly conferring anti-inflammatory as well as antithrombotic effects.
Welt
Frederick G P
FG
West Roxbury VA Medical Center, West Roxbury, Massachusetts, USA. welt@mit.edu
Rogers
Sarah D
SD
Zhang
Xiaobin
X
Ehlers
Raila
R
Chen
Zhiping
Z
Nannizzi-Alaimo
Lisa
L
Phillips
David R
DR
Simon
Daniel I
DI
D000077284:Abciximab; D000368:Aged; D000704:Analysis of Variance; D000911:Antibodies, Monoclonal / Q000494:pharmacology; D001241:Aspirin / Q000494:pharmacology; D023201:CD40 Ligand / Q000097:blood*; D018946:Chemokine CCL5 / Q000097:blood*; D003327:Coronary Disease / Q000097:blood* / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D000077542:Eptifibatide; D005260:Female; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000494:pharmacology*; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018946:Chemokine CCL5; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D023201:CD40 Ligand; D006493:Heparin; D000077542:Eptifibatide; D001241:Aspirin; D000077284:Abciximab