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Patient-specific dosing of IIb/IIIa antagonists during acute coronary syndromes: rationale and design of the PARAGON B study. The PARAGON B International Steering Committee.
Am Heart J. 2000 Apr; 139(4):563-6.AH

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+Show Affiliations

Department of Cardiology and C (Cleveland Clinic Cardiovascular Coordinating Center), The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. molited@ccf.org

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10740135

Citation

Moliterno, D J.. "Patient-specific Dosing of IIb/IIIa Antagonists During Acute Coronary Syndromes: Rationale and Design of the PARAGON B Study. the PARAGON B International Steering Committee." American Heart Journal, vol. 139, no. 4, 2000, pp. 563-6.
Moliterno DJ. Patient-specific dosing of IIb/IIIa antagonists during acute coronary syndromes: rationale and design of the PARAGON B study. The PARAGON B International Steering Committee. Am Heart J. 2000;139(4):563-6.
Moliterno, D. J. (2000). Patient-specific dosing of IIb/IIIa antagonists during acute coronary syndromes: rationale and design of the PARAGON B study. The PARAGON B International Steering Committee. American Heart Journal, 139(4), 563-6.
Moliterno DJ. Patient-specific Dosing of IIb/IIIa Antagonists During Acute Coronary Syndromes: Rationale and Design of the PARAGON B Study. the PARAGON B International Steering Committee. Am Heart J. 2000;139(4):563-6. PubMed PMID: 10740135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient-specific dosing of IIb/IIIa antagonists during acute coronary syndromes: rationale and design of the PARAGON B study. The PARAGON B International Steering Committee. A1 - Moliterno,D J, PY - 2000/3/31/pubmed PY - 2000/6/3/medline PY - 2000/3/31/entrez SP - 563 EP - 6 JF - American heart journal JO - Am Heart J VL - 139 IS - 4 N2 - 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. SN - 0002-8703 UR - https://www.unboundmedicine.com/medline/citation/10740135/Patient_specific_dosing_of_IIb/IIIa_antagonists_during_acute_coronary_syndromes:_rationale_and_design_of_the_PARAGON_B_study__The_PARAGON_B_International_Steering_Committee_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(00)90031-0 DB - PRIME DP - Unbound Medicine ER -