Additive effects between platelet concentrates and desmopressin in antagonizing the platelet glycoprotein IIb/IIIa inhibitor eptifibatide.

Abstract

BACKGROUND:

Platelet (PLT) glycoprotein (GP) IIb/IIIa receptor antagonists have demonstrated efficacy in decreasing ischemic complications of percutaneous coronary intervention and/or unstable angina. In case of bleeding, the drug can be stopped and PLT transfusions can be given.

STUDY DESIGN AND METHODS:

This crossover study tested the additive effects of PLT concentrates (PCs) after desmopressin (DDAVP) infusion in antagonizing the anti-PLT effects of GPIIb/IIIa inhibitors and aspirin. After eptifibatide and aspirin infusion (at standard dosages), 10 healthy volunteers received DDAVP or placebo. Thereafter, increasing amounts of PLTs from fresh single-donor apheresis concentrates were added in vitro to blood samples of all volunteers to increase PLT counts by 30 x 10(9), 60 x 10(9), or 120 x 10(9) per L.

RESULTS:

Adding platelets in vitro further improved PLT function after DDAVP: it shortened collagen-adenosine diphosphate closure times (p < 0.01), to normal ranges as measured by the PLT function analyzer (PFA-100). In contrast, normal PLT function could not be restored even when PLT counts were increased by 50 percent (120 x 10(9)/L) in the placebo group.

CONCLUSION:

Combined use of PLTs from fresh apheresis PC and DDAVP additively enhances recovery of normal PLT function after eptifibatide infusion. Such a strategy may help to avoid excessive transfusion of PC.

• Authors: Rosemarie Reiter, Petra Jilma-Stohlawetz, Michaela Horvath, Bernd Jilma
• Journal: Transfusion (Transfusion) Vol. 45 Issue 3 Pg. 420-6 (Mar 2005) ISSN: 0041-1132 [Print] United States
• PMID: 15752161 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anticoagulants
• Hemostatics
• Hirudins
• Peptides
• Platelet Aggregation Inhibitors
• Platelet Glycoprotein GPIIb-IIIa Complex
• Recombinant Proteins
• Deamino Arginine Vasopressin
• Eptifibatide
• Aspirin
• lepirudin

Topics

• Adult
• Anticoagulants
• Aspirin (administration & dosage)
• Blood Component Removal
• Blood Platelets (drug effects)
• Cross-Over Studies
• Deamino Arginine Vasopressin (administration & dosage)
• Drug Synergism
• Eptifibatide
• Hemostatics (administration & dosage)
• Hirudins (analogs & derivatives)
• Humans
• Male
• Peptides (administration & dosage)
• Platelet Aggregation Inhibitors (administration & dosage)
• Platelet Glycoprotein GPIIb-IIIa Complex (antagonists & inhibitors)
• Platelet Transfusion
• Recombinant Proteins