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June 14, 2004HeartOpen Access

Distinct yet complementary mechanisms of heparin and glycoprotein IIb/IIIa inhibitors on platelet activation and aggregation: implications for restenosis during percutaneous coronary intervention

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Why the study?

Does unfractionated heparin or low molecular weight heparin combined with Gp IIb/IIIa blockers improve inhibition of platelet activation and aggregation in thrombin-stimulated platelets?

Population

Washed platelets stimulated with thrombin (in vitro model)

Comparison

Unfractionated heparin or low molecular weight… vs Absence of UFH, LMWH, and Gp IIb/IIIa blockers

Design

Preclinical

Authors

JDJonathan DayUniversity of Cape Town

Discussion

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Overview

In vitro UFH superiority over LMWH warrants no practice change; leaves open translation to clinical platelet inhibition with Gp IIb/IIIa blockers.

Structured PICO

Does unfractionated heparin or low molecular weight heparin combined with Gp IIb/IIIa blockers improve inhibition of platelet activation and aggregation in thrombin-stimulated platelets?

P
Population
Washed platelets stimulated with thrombin (in vitro model)
I
Intervention
Unfractionated heparin (UFH) or low molecular weight heparin (LMWH) in combination with a glycoprotein (Gp) IIb/IIIa blocker (abciximab, eptifibatide, or tirofiban)
C
Comparator
Absence of UFH, LMWH, and Gp IIb/IIIa blockers
O
Outcome
Platelet activation and aggregation (including P selectin expression and platelet derived growth factor release)surrogate

In vitro, unfractionated heparin is more effective than low molecular weight heparin at inhibiting upstream platelet activation when coadministered with Gp IIb/IIIa blockers.

Cite This Study

Jonathan Day (2004) studied this question.

synapsesocial.com/papers/6a7ef164088720e7049b271bhttps://doi.org/10.1136/hrt.2003.017749

Topics

Dual antiplatelet therapyAnticoagulation in AF
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Local Delivery of Enoxaparin to Decrease Restenosis After Stenting: Results of Initial Multicenter Trial2001 · 51 citations
  2. 2Binding of Thrombin to Glycoprotein Ib Accelerates the Hydrolysis of Par-1 on Intact Platelets2001 · 231 citations
  3. 3Platelet Activation With Unfractionated Heparin at Therapeutic Concentrations and Comparisons With a Low-Molecular-Weight Heparin and With a Direct Thrombin Inhibitor1998 · 385 citations