Abstract | BACKGROUND:
Acute coronary syndromes, the leading cause of hospitalizations among adults, are frequently the sequelae of atherothrombotic events associated with coronary arterial plaque rupture. Beyond the usual antithrombotic therapies ( aspirin and heparin), potent antiplatelet agents, glycoprotein IIb/IIIa receptor antagonists, have been shown to improve patient outcome. Lamifiban is a short-acting, renally excreted IIb/IIIa antagonist that was found in post hoc analyses of the Platelet IIb/IIIa Antagonism for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network ( PARAGON A) study to reduce the 30-day incidence of death or myocardial infarction by 40% when plasma concentrations of 18 to 42 ng/mL were achieved. METHODS AND RESULTS: To determine if lamifiban, dosed according to creatinine clearance, could decrease the rates of death, myocardial infarction, or refractory ischemia, a randomized, double-blind, placebo-controlled trial was undertaken. In 26 countries, 5228 patients seen within 12 hours of symptom onset of a non-ST-elevation acute coronary syndrome were randomly assigned to placebo or lamifiban bolus and infusion. CONCLUSION: The plasma concentration of small-molecule IIb/IIIa inhibitors is strongly influenced by renal function, and renal-specific dosing of these agents may improve outcome among patients with acute coronary syndromes. The PARAGON B trial is testing this hypothesis.
|
Authors | D J Moliterno |
Journal | American heart journal
(Am Heart J)
Vol. 139
Issue 4
Pg. 563-6
(Apr 2000)
ISSN: 0002-8703 [Print] United States |
PMID | 10740135
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Acetates
- Platelet Aggregation Inhibitors
- Platelet Glycoprotein GPIIb-IIIa Complex
- Tyrosine
- lamifiban
|
Topics |
- Acetates
(administration & dosage, adverse effects)
- Adult
- Aged
- Cohort Studies
- Coronary Artery Disease
(diagnosis, drug therapy, mortality)
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Administration Schedule
- Electrocardiography
(drug effects)
- Female
- Humans
- Infusions, Intravenous
- Male
- Middle Aged
- Myocardial Infarction
(diagnosis, drug therapy, mortality)
- Myocardial Revascularization
- Platelet Aggregation Inhibitors
(administration & dosage, adverse effects)
- Platelet Glycoprotein GPIIb-IIIa Complex
(antagonists & inhibitors)
- Survival Rate
- Tyrosine
(administration & dosage, adverse effects, analogs & derivatives)
|