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Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide.
Circulation. 2002 Sep 17; 106(12):1470-6.Circ

Abstract

BACKGROUND

The relative anti-aggregatory effects of currently prescribed platelet glycoprotein IIb/IIIa receptor antagonists during and after percutaneous coronary intervention for acute coronary syndromes have not been established.

METHODS AND RESULTS

We randomized 70 acute coronary syndrome patients undergoing percutaneous coronary intervention to receive abciximab, eptifibatide, or tirofiban at doses used in the Evaluation of Platelet IIb/IIIa Inhibitor for STENTing (EPISTENT), Platelet glycoprotein IIb/IIIa in Unstable angina Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet Receptor Inhibition in ischemic Syndrome Management in Patients Limited by Unstable Signs and symptoms (PRISM-PLUS)/Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis (RESTORE) trials, respectively. Platelet aggregation (PA) in response to 20 micro mol/L of adenosine diphosphate was measured with turbidimetric aggregometry in both D-phenylalanyl-L-prolyl-L-arginine chloromethylketone and citrate-anticoagulated blood early (15 and 30 minutes) and late (4, 12, and 18 to 24 hours) after drug initiation. At 15 and 30 minutes, PA was significantly less inhibited by the tirofiban-RESTORE regimen compared with abciximab (P=0.028) and eptifibatide regimens (P=0.0001). The abciximab regimen, however, showed increasingly varied anti-aggregatory effects during continued infusion for > or =4 hours. Citrate exaggerated ex vivo platelet inhibition after eptifibatide and tirofiban, but had the opposite effect on abciximab. Of all regimens evaluated, the eptifibatide regimen inhibited PA most consistently throughout both the early and late periods.

CONCLUSIONS

Currently recommended drug regimens to inhibit the platelet glycoprotein IIb/IIIa receptor have distinct pharmacodynamic profiles that might affect their relative efficacy in acute coronary syndromes and percutaneous coronary intervention.

Authors+Show Affiliations

Tallahassee Heart and Vascular Institute, Tallahassee Memorial Healthcare, Tallahassee, Fla 32308, USA. batch002@earthlink.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

12234950

Citation

Batchelor, Wayne B., et al. "Randomized COMparison of Platelet Inhibition With Abciximab, tiRofiban and Eptifibatide During Percutaneous Coronary Intervention in Acute Coronary Syndromes: the COMPARE Trial. Comparison of Measurements of Platelet Aggregation With Aggrastat, Reopro, and Eptifibatide." Circulation, vol. 106, no. 12, 2002, pp. 1470-6.
Batchelor WB, Tolleson TR, Huang Y, et al. Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide. Circulation. 2002;106(12):1470-6.
Batchelor, W. B., Tolleson, T. R., Huang, Y., Larsen, R. L., Mantell, R. M., Dillard, P., Davidian, M., Zhang, D., Cantor, W. J., Sketch, M. H., Ohman, E. M., Zidar, J. P., Gretler, D., DiBattiste, P. M., Tcheng, J. E., Califf, R. M., & Harrington, R. A. (2002). Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide. Circulation, 106(12), 1470-6.
Batchelor WB, et al. Randomized COMparison of Platelet Inhibition With Abciximab, tiRofiban and Eptifibatide During Percutaneous Coronary Intervention in Acute Coronary Syndromes: the COMPARE Trial. Comparison of Measurements of Platelet Aggregation With Aggrastat, Reopro, and Eptifibatide. Circulation. 2002 Sep 17;106(12):1470-6. PubMed PMID: 12234950.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide. AU - Batchelor,Wayne B, AU - Tolleson,Thaddeus R, AU - Huang,Yao, AU - Larsen,Rhonda L, AU - Mantell,R Michael, AU - Dillard,Patricia, AU - Davidian,Marie, AU - Zhang,Daowen, AU - Cantor,Warren J, AU - Sketch,Michael H,Jr AU - Ohman,E Magnus, AU - Zidar,James P, AU - Gretler,Daniel, AU - DiBattiste,Peter M, AU - Tcheng,James E, AU - Califf,Robert M, AU - Harrington,Robert A, PY - 2002/9/18/pubmed PY - 2002/10/4/medline PY - 2002/9/18/entrez SP - 1470 EP - 6 JF - Circulation JO - Circulation VL - 106 IS - 12 N2 - BACKGROUND: The relative anti-aggregatory effects of currently prescribed platelet glycoprotein IIb/IIIa receptor antagonists during and after percutaneous coronary intervention for acute coronary syndromes have not been established. METHODS AND RESULTS: We randomized 70 acute coronary syndrome patients undergoing percutaneous coronary intervention to receive abciximab, eptifibatide, or tirofiban at doses used in the Evaluation of Platelet IIb/IIIa Inhibitor for STENTing (EPISTENT), Platelet glycoprotein IIb/IIIa in Unstable angina Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet Receptor Inhibition in ischemic Syndrome Management in Patients Limited by Unstable Signs and symptoms (PRISM-PLUS)/Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis (RESTORE) trials, respectively. Platelet aggregation (PA) in response to 20 micro mol/L of adenosine diphosphate was measured with turbidimetric aggregometry in both D-phenylalanyl-L-prolyl-L-arginine chloromethylketone and citrate-anticoagulated blood early (15 and 30 minutes) and late (4, 12, and 18 to 24 hours) after drug initiation. At 15 and 30 minutes, PA was significantly less inhibited by the tirofiban-RESTORE regimen compared with abciximab (P=0.028) and eptifibatide regimens (P=0.0001). The abciximab regimen, however, showed increasingly varied anti-aggregatory effects during continued infusion for > or =4 hours. Citrate exaggerated ex vivo platelet inhibition after eptifibatide and tirofiban, but had the opposite effect on abciximab. Of all regimens evaluated, the eptifibatide regimen inhibited PA most consistently throughout both the early and late periods. CONCLUSIONS: Currently recommended drug regimens to inhibit the platelet glycoprotein IIb/IIIa receptor have distinct pharmacodynamic profiles that might affect their relative efficacy in acute coronary syndromes and percutaneous coronary intervention. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/12234950/Randomized_COMparison_of_platelet_inhibition_with_abciximab_tiRofiban_and_eptifibatide_during_percutaneous_coronary_intervention_in_acute_coronary_syndromes:_the_COMPARE_trial__Comparison_Of_Measurements_of_Platelet_aggregation_with_Aggrastat_Reopro_and_Eptifibatide_ L2 - https://www.ahajournals.org/doi/10.1161/01.cir.0000029744.01096.1f?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -