title: GPIIb-IIIa antagonists reduce thromboinflammatory processes in patients with acute coronary syndromes undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  To investigate the effects of abciximab, eptifibatide and no GPIIb-IIIa antagonist (control) on soluble CD40 ligand (sCD40L) and the formation of leukocyte-platelet aggregates (LPA) in 98 ACS patients undergoing percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  sCD40L and LPA are increased in patients with ACS.
  
  
  METHODS
  sCD40L was measured by enzyme-linked immunosorbent assay (ELISA) and LPA by whole blood flow cytometry.
  
  
  RESULTS
  There were no baseline differences between the three groups in sCD40L and LPA. At the end of PCI, sCD40L was unchanged in the controls, decreased by 30% (P < 0.001) in the abciximab group and by 11% (P < 0.02) in the eptifibatide group. Eighteen to 24 h after PCI, sCD40L was unchanged in the controls, reduced 30% (P < 0.001) in the abciximab-treated group and 9% (P < 0.01) in the eptifibatide-treated group. At the end of PCI, circulating monocyte-platelet aggregates (MPA) were reduced by 12% (P = NS) in the abciximab-treated group, 13% in the eptifibatide-treated group (P = NS), but slightly increased in the controls (P = NS). Eighteen to 24 h after PCI, MPA were reduced by 41% (P < 0.001) compared to baseline in the abciximab-treated group, by 23% (P = NS) in the eptifibatide-treated group, and 15% (P = NS) in the controls. In contrast to control patients presenting while on clopidogrel, control patients presenting not on clopidogrel demonstrated a reduction in sCD40L and LPA 18-24 h post-PCI (P = NS). At low receptor occupancy, GPIIb-IIIa antagonists did not augment the release of sCD40L or the number of circulating LPA.
  
  
  CONCLUSIONS
  GPIIb-IIIa antagonists reduce circulating sCD40L and LPA formation in patients with ACS undergoing PCI. At low receptor occupancy, GPIIb-IIIa antagonists do not activate platelets.
authors.affiliation: Cardiac Catheterization Laboratories, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA 01605, USA. mark.furman@umassmed.edu
authors.forename: M I
authors.initials: MI
authors.lastname: Furman
authors.forename: L A
authors.initials: LA
authors.lastname: Krueger
authors.forename: M D
authors.initials: MD
authors.lastname: Linden
authors.forename: M L
authors.initials: ML
authors.lastname: Fox
authors.forename: S P
authors.initials: SP
authors.lastname: Ball
authors.forename: M R
authors.initials: MR
authors.lastname: Barnard
authors.forename: A L
authors.initials: AL
authors.lastname: Frelinger
authors.forename: A D
authors.initials: AD
authors.lastname: Michelson
mesh_terms: D000077284:Abciximab; D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000494:pharmacology; D001792:Blood Platelets / Q000473:pathology; D023201:CD40 Ligand / Q000097:blood; D000077144:Clopidogrel; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000494:pharmacology; D007249:Inflammation / Q000188:drug therapy; D007962:Leukocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010973:Platelet Adhesiveness / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D023201:CD40 Ligand; D000077144:Clopidogrel; D013988:Ticlopidine; D000077284:Abciximab