Abstract:
OBJECTIVES:We designed a study to explore the effect of glycoprotein (GP) IIb/IIIa blockade on the atherosclerotic plaque and distal coronary vasculature. BACKGROUND:Platelet GP IIb/IIIa blockers have been proven to be beneficial in acute ischemic syndromes. This effect has also been attributed to the prevention of microvascular obstruction, although the underlying mechanisms have not been fully defined. METHODS:Eighteen patients with unstable refractory angina pectoris underwent cardiac catheterization and angioplasty. Trans-stenotic and microvascular resistances to flow were measured at baseline, during hyperventilation, and after intracoronary adenosine. Measurements were repeated early after abciximab administration and after successful percutaneous transluminal coronary angioplasty. RESULTS:Hyperventilation induced an ischemic attack in 12 of 18 patients and increased epicardial (12.8 +/- 16.9 vs. 6.1 +/- 6.1 mm Hg/ml per min, p < 0.05) and microvascular (9.9 +/- 7.5 vs. 6.8 +/- 5.8 mm Hg/ml per min, p < 0.05) coronary resistance. Abciximab had no significant effect on epicardial resistance, although it significantly reduced distal coronary resistance under all study conditions, including baseline (4.8 +/- 4.8 mm Hg/ml per min, p < 0.01), hyperventilation (5.1 +/- 5.4 mm Hg/ml per min, p < 0.01), and intracoronary adenosine (2.7 +/- 3.0 vs. 4.3 +/- 4.3 mm Hg/ml per min, p < 0.05). The hyperventilation test became negative in all patients after abciximab administration. CONCLUSIONS:These observations confirm the immediate beneficial effects of platelet GP IIb/IIIa blockade with abciximab in acute ischemic syndromes and suggest that improvement of microvascular function may play a central role in the mechanism of action of this drug.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Marzilli M,Sambuceti G,Testa R,Fedele Sdoi
10.1016/s0735-1097(02)02590-1subject
Has Abstractpub_date
2002-12-18 00:00:00pages
2102-9issue
12eissn
0735-1097issn
1558-3597pii
S0735109702025901journal_volume
40pub_type
临床试验,杂志文章abstract:OBJECTIVES:In a computed tomographic (CT) angiography study, we identified the characteristics of atherosclerotic lesions that were associated with subsequent development of acute coronary syndrome (ACS). BACKGROUND:The CT characteristics of culprit lesions in ACS include positive vessel remodeling (PR) and low-attenu...
journal_title:Journal of the American College of Cardiology
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更新日期:2017-12-26 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1993-04-01 00:00:00
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doi:10.1016/s0735-1097(88)80020-2
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更新日期:2004-02-04 00:00:00
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更新日期:2007-11-06 00:00:00
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doi:10.1016/s0735-1097(85)80324-7
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更新日期:2019-04-23 00:00:00
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更新日期:1985-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:1983-11-01 00:00:00
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更新日期:1992-03-15 00:00:00
abstract::The effectiveness of an intermittent regimen of transdermal nitroglycerin in chronic stable angina was evaluated in 206 patients using serial treadmill testing. After a placebo stabilization phase, patients were randomized to 4 weeks of double-blind treatment with transdermal nitroglycerin, 10 or 20 cm2 (equivalent to...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1989-03-15 00:00:00