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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4011_Библиотеки_им_академика_М_И_Перельмана
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470 Index
conjunctive heparin and vascular access
site management, 195, 196
direct thrombin inhibitors,
glycoprotein IIb/IIIa receptor antagonist
combination trials, 358, 359
management, 356, 357
economic analysis,
abciximab,
CAPTURE, 312
EPIC, 309–311
EPILOG, 311, 312
EPISTENT, 312, 313
eptifibatide,
ESPRIT, 314, 315
IMPACT II, 314
tirofiban and RESTORE trial, 315
eptifibatide trials,
ESPRIT,
baseline characteristics of
participants, 139, 140
clinical efficacy, 140–145
safety, 143, 144
study design, 136–138
subgroup analysis, 140
IMPACT II,
adverse events, 131
clinical efficacy, 128–130
composite endpoint components, 131
dosing issues, 132, 134
study design, 127, 128
time to events, 130, 131
phase II trials,
IMPACT, 127
IMPACT Hi/Low, 127
PRIDE, 134, 136
PURSUIT, 134
facilitated percutaneous coronary
intervention, 445, 446
glycoprotein IIb/IIIa receptor antagonists,
agent selection, 195
indications, 194, 195
non-ST-elevation acute coronary
syndromes, 428, 429
rationale for use, 427, 428
ST-elevation myocardial infarction,
429–431
trial designs,
ADMIRAL, 176
algorithms, 170, 171
CADILLAC, 176
CAPTURE, 175
entry criteria, 172
EPIC, 169
EPILOG, 169
EPISTENT, 174
ESPRIT, 174, 175
heparin regimens and vascular
sheath removal, 173
IMPACT II, 174
ISAR-2, 175, 176
RAPPORT, 175
RESTORE, 175
TARGET, 176
inflammatory response, 388–390
intertrial comparison,
clinical efficacy,
endpoint at 30 d, 179–183
general blockade effects, 190, 191
patient subgroups, 182
specific agent comparison, 191, 192
combination therapy, 178, 179
drug regimens, 177, 178
entry criteria, 177
heparin regimens and vascular access
site management, 178
long-term efficacy,
acute ischemic endpoints, 184, 185
mortality, 185, 186
overview, 182, 184
safety, 187–189
target vessel revascularization,
186, 187
safety,
bleeding, 192, 193
emergency coronary bypass
surgery, 193
readministration, 194
thrombocytopenia, 189, 193, 194
trial conduct and endpoints, 179
low-molecular-weight heparin therapy,
clinical studies, 350
glycoprotein IIb/IIIa receptor antagonist
combination trials, 352, 354
hematologic considerations, 349, 350
intravenous administration, 351, 352
stroke risks, 410
tirofiban trials,
dosing considerations, 158–160
PRISM-PLUS,
analysis, 162
clinical efficacy, 161, 162
study design, 160, 161
https://t.me/med1917
Index 471
RESTORE,
analysis, 153–155
clinical efficacy, 152, 153
study design, 151, 152
TACTICS-TIMI 18
analysis, 163, 268
clinical efficacy, 163, 266–268
cost effectiveness, 269, 270
study design, 162, 163, 266
TARGET,
analysis, 158
clinical efficacy, 156, 157
study design, 155, 156
unstable angina, see Unstable angina
Peripheral artery disease (PAD), glycoprotein
IIb/IIIa receptor blockade, 448
PFA-100, platelet function assay, 330–332
Pharmacokinetics,
abciximab, 84–87
eptifibatide, 88–90
tirofiban, 87, 88
Phospholipase A2 (PLA2), signaling
cross-talk, 51
Phospholipase C (PLC), signaling cross-talk, 51
PKC, see Protein kinase C
PLA2, see Phospholipase A2
PlA2, glycoprotein IIb/IIIa receptor poly-
morphism and cardiovascular risks,
56, 57, 376, 449
Plaque, see Atherosclerotic plaque
Platelet,
adhesion,
receptors, see also Glycoprotein IIb/IIIa
receptor,
collagen receptors, 31
glycoprotein Ib/IX receptor, 30, 31
integrins, 27–30
overview, 26, 27
substrate proteins,
nonmatrix sources of matrix
proteins, 25, 26
shear effects on substrates, 26
subendothelial matrix, 13, 14, 24, 25
aggregation, see also Glycoprotein IIb/
IIIa receptor,
history of study, 77, 78
inducers, 77
measurement, 76, 77, 321, 322
antiplatelet agent mechanisms in
thrombosis, 13
deposition in thrombosis, 79
granule content, 14
inhibition assays,
bleeding time, 328
Clot Signature Analyzer, 333, 334
cone and platelet analyzer, 332
electrical impedance aggregometry, 327
flow cytometry, 327, 328
PFA-100, 330–332
platelet count ratio, 333
precautions,
calcium chelator effects, 334, 335
inhibition level optimization, 335
multiple agent studies, 334
rapid platelet function assay, 328–330
thromboelastography, 332, 333
turbidimetric aggregometry, 326
inhibition levels,
bleeding complications, 325, 326
thrombotic event protection,
animal studies, 322
direct evidence from clinical trials,
323–325
indirect data from clinical trials,
322, 323
integrin receptors, 27–30, 77, 79
myocardial infarction role,
pathophysiology, 73–75
reperfusion limitations, 277, 278
thrombogenic substances, 13
Platelet count ratio, platelet function assay, 333
Platelet-derived growth factor (PDGF),
glycoprotein IIb/IIIa receptor antago-
nist effects, 59, 60
PLC, see Phospholipase C
PRIDE, eptifibatide dosing, 134, 136
PRISM,
non-ST-elevation acute coronary
syndromes, glycoprotein IIb/IIIa
receptor blockade, 433
unstable angina trial,
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 240, 242, 244, 245
patient selection, 241, 242
primary therapy vs percutaneous
intervention effect, 255–257
study designs, 241
https://t.me/med1917
472 Index
PRISM-PLUS,
analysis, 162
clinical efficacy, 161, 162
non-ST-elevation acute coronary
syndromes, glycoprotein IIb/IIIa
receptor blockade, 433
study design, 160, 161
unstable angina trial,
angiographic observations, 268, 269
benefits, 264, 265
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
high-risk patient targeting, 265, 266
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 189, 190, 240, 242, 244, 245
patient selection, 241, 242
primary therapy vs percutaneous
intervention effect, 255–257
safety, 269
study designs, 241
Prostacyclin, synthesis, 5
Protein C, coagulation modulation, 18
Protein kinase C (PKC), signaling cross-talk, 51
Protein S, coagulation modulation, 18
P-selectin, platelet expression, 42, 278
PURSUIT,
dosing of eptifibatide, 134, 442
economic analysis, 315–317
geographic differences in outcomes,
446, 447
non-ST-elevation acute coronary
syndromes, glycoprotein IIb/IIIa
receptor blockade, 435
unstable angina trial,
angiographic observations, 268, 269
benefits, 264, 265
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
high-risk patient targeting, 265, 266
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 189, 190, 245–247
patient selection, 241, 242
primary therapy vs percutaneous
intervention effect, 255–257
study designs, 241
R
Rapid platelet function assay (RPFA),
overview, 328–330, 443
RAPPORT,
acute myocardial infarction, percutaneous
coronary intervention, and abciximab
therapy, 281
intertrial comparison,
clinical efficacy,
endpoint at 30 d, 179–183
general blockade effects, 190, 191
patient subgroups, 182
specific agent comparison, 191, 192
combination therapy, 178, 179
drug regimens, 177, 178
entry criteria, 177
heparin regimens and vascular access
site management, 178
long-term efficacy,
acute ischemic endpoints, 184, 185
mortality, 185, 186
overview, 182, 184
safety, 187–189
target vessel revascularization,
186, 187
safety,
bleeding, 192, 193
emergency coronary bypass
surgery, 193
readministration, 194
thrombocytopenia, 189, 193, 194
trial conduct and endpoints, 179
ST-elevation myocardial infarction,
430, 431
study design,
algorithms, 170, 171
entry criteria, 172
heparin regimens and vascular sheath
removal, 173
overview, 175
RESTORE,
analysis, 153–155
clinical efficacy, 152, 153
dosing of tirofiban, 442
economic analysis, 315
intertrial comparison,
clinical efficacy,
endpoint at 30 d, 179–183
general blockade effects, 190, 191
patient subgroups, 182
specific agent comparison, 191, 192
https://t.me/med1917
Index 473
combination therapy, 178, 179
drug regimens, 177, 178
entry criteria, 177
heparin regimens and vascular access
site management, 178
long-term efficacy,
acute ischemic endpoints, 184, 185
mortality, 185, 186
overview, 182, 184
safety, 187–189
target vessel revascularization,
186, 187
safety,
bleeding, 192, 193
emergency coronary bypass
surgery, 193
readministration, 194
thrombocytopenia, 189, 193, 194
trial conduct and endpoints, 179
study design,
algorithms, 170, 171
entry criteria, 172
heparin regimens and vascular sheath
removal, 173
overview, 151, 152, 175
Roxifiban,
limitations, 379, 380
meta-analysis of oral drugs, 378, 379
pharmacology, 366, 367
phase II trials, 367–369
phase III trials,
overview, 366–368
study design, 368–371
RPFA, see Rapid platelet function assay
S
Sibrafiban,
limitations, 379, 380
meta-analysis of oral drugs, 378, 379
pharmacology, 366, 367
phase II trials, 367–369
phase III trials,
efficacy and safety, 377, 377
overview, 366–368
study design, 368–371
SYMPHONY, 370, 372, 376, 377
SMC, see Smooth muscle cell
Smooth muscle cell (SMC), macrophage
killing, 390
ST-elevation myocardial infarction, see
Myocardial infarction, acute
STOP-AMI, acute myocardial infarction,
percutaneous coronary intervention
and abciximab therapy, 280
Streptokinase,
fibrinolytic therapy, see Fibrinolysis
history of use, 4
Stroke,
abciximab in acute stroke, 401
aspirin benefits, 74, 75, 412, 413, 415
cerebral angiograms of left middle
cerebral artery occlusion and
treatment, 418–420
clopidogrel prevention trials, 413
coronary artery disease and treatment
complication,
hemorrhagic stroke, 410–412
ischemic stroke, 409, 410
fibrinolytic therapy, 447
hemorrhagic stroke complication during
acute ischemic stroke therapy,
415, 416
percutaneous carotid intervention, see
Carotid angioplasty and stenting
ticlopidine prevention trials, 413
SYMPHONY, study design and outcomes,
370, 372, 376, 377, 437
T
TACTICS-TIMI 18
tirofiban trial,
analysis, 163, 268
clinical efficacy, 163, 266–268
cost effectiveness, 269, 270
study design, 162, 163, 266
unstable angina, 266–270
upstream therapy, 444
TAMI 8, fibrinolysis, acute myocardial
ischemia, and glycoprotein IIb/IIIa
receptor blockade, 290
TARGET,
analysis, 158
clinical efficacy, 156, 157
economic analysis, 317, 318
intertrial comparison,
clinical efficacy,
endpoint at 30 d, 179–183
general blockade effects, 190, 191
patient subgroups, 182
specific agent comparison, 191, 192
combination therapy, 178, 179
drug regimens, 177, 178
https://t.me/med1917
474 Index
entry criteria, 177
heparin regimens and vascular access
site management, 178
long-term efficacy,
acute ischemic endpoints, 184, 185
mortality, 185, 186
overview, 182, 184
safety, 187–189
target vessel revascularization,
186, 187
safety,
bleeding, 192, 193
emergency coronary bypass
surgery, 193
readministration, 194
thrombocytopenia, 189, 193, 194
trial conduct and endpoints, 179
non-ST-elevation acute coronary
syndromes, 430
study design,
algorithms, 170, 171
entry criteria, 172
heparin regimens and vascular sheath
removal, 173
overview, 155, 156, 176
TEG, see Thromboelastography
Thienopyridines, see Clopidogrel; Ticlopidine
Thrombin,
direct inhibitors,
acute coronary syndrome trials, 355, 356
advantages, 440, 441
percutaneous coronary intervention,
glycoprotein IIb/IIIa receptor
antagonist combination trials,
358, 359
management, 356, 357
types, 347
receptors and signaling cross-talk, 49, 50
structure, 343, 344
thrombosis role, 17, 18, 343, 344
Thrombocytopenia, glycoprotein IIb/IIIa
receptor antagonist safety, 189, 193,
194, 443, 444
Thromboelastography (TEG), platelet function
assay, 332, 333, 348
Thrombomodulin, functions, 17, 18
Thrombospondin, platelet adhesion, 25, 26
Ticlopidine,
adverse events, 439
percutaneous carotid intervention
adjunctive therapy, 400, 414
stroke prevention trials, 413
unstable angina management, 235, 236
TIMI-12, outcomes, 436
Tirofiban,
abciximab comparison, 164
antithrombin combination therapy, 348
economic analysis,
abciximab comparison in TARGET,
317, 318
percutaneous coronary intervention,
RESTORE trial, 315
evidence-based selection, 450
low-molecular-weight heparin combination
therapy, 352, 354, 355
percutaneous coronary intervention trials,
dosing considerations, 158–160
PRISM-PLUS,
analysis, 162
clinical efficacy, 161, 162
study design, 160, 161
RESTORE,
analysis, 153–155
clinical efficacy, 152, 153
study design, 151, 152
TACTICS-TIMI 18
analysis, 163
clinical efficacy, 163
study design, 162, 163
TARGET,
analysis, 158
clinical efficacy, 156, 157
study design, 155, 156
pharmacodynamics, 87, 88, 148–151,
168, 386
pharmacology, 148
receptor selectivity, 87
structure, 148
trials, see PRISM; PRISM-PLUS;
RESTORE; TACTICS-TIMI 18;
TARGET
unstable angina trials, see also PRISM;
PRISM-PLUS,
angiographic observations, 268, 269
benefits, 264, 265
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
high-risk patient targeting, 265, 266
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
https://t.me/med1917
Index 475
overview, 240, 242, 244, 245
patient selection, 241, 242
primary therapy vs percutaneous
intervention effect, 255–257
study designs, 241
Tissue plasminogen activator, see Fibrinolysis
TNF-α, see Tumor necrosis factor-α
Troponin-T, risk assessment in CAPTURE
trial, 221, 222, 446
Tumor necrosis factor-α (TNF-α),
atherosclerotic plaque rupture role, 11, 12
Turbidimetric aggregometry, platelet function
assay, 326
Tyrosine kinase, glycoprotein IIb/IIIa receptor
outside-in signaling, 52–54
U
Ultegra-RPFA, see Rapid platelet function
assay
Unstable angina,
abciximab trials, see also CAPTURE;
GUSTO-IV,
angiographic observations, 268, 269
benefits, 264, 265
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
high-risk patient targeting, 265, 266
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 237, 238
patient selection, 241, 242
primary therapy vs percutaneous
intervention effect, 255–257
study designs, 241
antiplatelet therapy,
aspirin, 235
clopidogrel, 236, 237
ticlopidine, 235, 236
CAPTURE trial of abciximab,
angiogram assessment, 207–209, 211,
212, 216, 222–225
arteriography and angioplasty, 207,
212, 213
baseline characteristics of patients,
215, 216
comparison with other trials, 226–229
electrocardiography, 206
endpoints,
4-yr follow-up, 219–221
30 d, 216–218
flow of patients, 214
independent data reporting measures, 206
patient selection, 204, 205
pilot trial outcomes, 209–213
prognostic factors, 219, 221, 222
safety, 218, 219
statistical analysis, 206, 207, 209
study design, 205, 206
classification of patients, 203, 233
eptifibatide trials, see also PURSUIT
angiographic observations, 268, 269
benefits, 264, 265
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
high-risk patient targeting, 265, 266
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 245–247
patient selection, 241, 242
primary therapy vs percutaneous inter-
vention effect, 255–257
study designs, 241
glycoprotein IIb/IIIa receptor antagonist
trials,
cost effectiveness, 269, 270
overview, 189, 190
treatment guidelines, 260
lamifiban trials, see also PARAGON-A;
PARAGON-B,
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
dosing, 258, 259
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 238–240
patient selection, 241, 242
primary therapy vs percutaneous inter-
vention effect, 255–257
study designs, 241
pathophysiology, 203, 233–235
tirofiban trials, see also PRISM;
PRISM-PLUS,
angiographic observations, 268, 269
benefits, 264, 265
bleeding events, 252–254
clinical outcomes, 243
concomitant heparin therapy, 259
https://t.me/med1917
476 Index
dosing, 258, 259
high-risk patient targeting, 265, 266
mortality, 248–252, 254
myocardial infarction, 251, 252, 254
overview, 240, 242, 244, 245
patient selection, 241, 242
primary therapy vs percutaneous
intervention effect, 255–257
study designs, 241
Urokinase, see Fibrinolysis
V
Vascular cell adhesion molecule (VCAM),
atherosclerotic plaque rupture role, 11
VCAM, see Vascular cell adhesion molecule
Vitronectin,
glycoprotein IIb/IIIa receptor binding, 46
platelet adhesion, 25, 26
receptor,
abciximab binding, 83, 168, 384–386
animal studies of antagonism, 385
ligands, 77, 78
von Willebrand factor (vWF),
glycoprotein IIb/IIIa receptor binding,
46, 47
platelet adhesion, 24, 25
receptors and signaling cross-talk, 50, 51
shear effects, 26
vWF, see von Willebrand factor
W
Warfarin, clinical trials, 440
X
Xemilofiban,
limitations, 379, 380
meta-analysis of oral drugs, 378, 379
pharmacology, 366, 367
phase II trials, 367–369
phase III trials,
efficacy and safety, 373, 374
EXCITE, 370, 373, 374
overview, 366–368
study design, 368–371
https://t.me/med1917
Contemporary Cardiology
™
Christopher P. Cannon, MD, Series Editor
Platelet Glycoprotein IIb/IIIa Inhibitors
in Cardiovascular Disease
S
ECOND
E
DITION
Edited by
A. Michael Lincoff,
MD
Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, OH
Contemporary Cardiology™
Platelet Glycoprotein IIb/IIIa Inhibitors
in Cardiovascular Disease, Second Edition
ISBN: 1-58829-185-5 E-ISBN: 1-59259-376-3
humanapress.com
Features
9781588 291851
90000
From Reviews of the First Edition:
“…provides the reader with extensive and profound information about this new class, based on data from
completed and ongoing trials…can be recommended not only to cardiologists but to all clinicians and
researchers interested in this field.” —I
NTENSIVE
C
ARE
M
EDICINE
“…as a single resource covering virtually the entire spectrum of information related to GP IIb/IIIa’s, it will
be extremely valuable to cardiology interventionists, healthcare practitioners…, and formulary committees
charged with cost-effective use of these expensive agents.” —A
NNALS
OF
P
HARMACOTHERAPY
A. Michael Lincoff takes advantage of critically important new knowledge arising from recent
clinical trials to update and expand his acclaimed Platelet Glycoprotein IIb/IIIa Inhibitors in Cardio-
vascular Disease. This substantially enhanced Second Edition contains new chapters on the role of
GPIIb/IIIa blockade during acute coronary syndromes, on outcomes with chronic oral GPIIb/IIIa
blockade following acute coronary syndromes, and on fibrinolytic therapy during acute myocardial
infarctions. Additional enhancements include revised findings from the latest trials of GPIIb/IIIa
inhibition during percutaneous coronary intervention, discussion of GPIIb/IIIa blockade with other
platelet and thrombin inhibitors, and a review of the potential effects beyond inhibition of platelet
aggregation. The book also explains the scientific basis of this therapy, evaluates its benefits and risks
for patients, and summarizes detailed data from its various clinical trials.
Comprehensive and definitive, Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease,
Second Edition offers physicians, cardiologists, emergency room doctors, and basic scientists a com-
plete and authoritative review of the state-of-the-art in glycoprotein IIb/IIIa receptor inhibitor
use today.
• Updated review of GPIIb/IIIa receptor inhibitors
by their scientific pioneers and principal clinical
investigators
• New chapters on the role of GPIIb/IIIa blockade
during percutaneous revascularization
• Advances with fibrinolytic therapy during acute
myocardial infarctions
• Discussion of GPIIb/IIIa blockade with other
platelet and thrombin inhibitors
• Clinical guidelines for the use of GPIIb/IIIa
receptor inhibitors
• Review of the scientific basis of GPIIb/IIIa
receptor inhibitors and their risks and benefits
for patients
https://t.me/med1917
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