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氯吡格雷加依替巴肽抑制血小板反应性:氯吡格雷加依替巴肽抑制血小板反应性(CLEARPlatelets)研究结果 被引量:28
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作者 Gurbel P.A. Bliden K.P. +1 位作者 Zaman K.A. 张迎捷 《世界核心医学期刊文摘(心脏病学分册)》 2005年第9期39-40,共2页
Background -Pretreatment is not the most common strategy practiced for clopidogrel administration in elective coronary stenting. Moreover, limited information is available on the antiplatelet pharmacodynamics of a 300... Background -Pretreatment is not the most common strategy practiced for clopidogrel administration in elective coronary stenting. Moreover, limited information is available on the antiplatelet pharmacodynamics of a 300-mg versus a 600-mg clopidogrel loading dose, and the comparative effect of eptifibatide with these regimens is unknown. Methods and Results -Patients undergoing elective stenting (n=120) were enrolled in a 2X2 factorial study(300 mg clopidogrel with or without eptifibatide; 600 mg clopidogrel with or without eptifibatide)(Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets[CLEAR PLATELETS] Study). Clopidogrel was administered immediately after stenting. Aggregometry and flow cytometry were used to assess platelet reactivity. Eptifibatide added a ≥2-fold increase in platelet inhibition to 600 mg clopidogrel alone at 3, 8, and 18 to 24 hours after stenting as measured by 5 μmol/L ADP-induced aggregation(P< 0.001). Without eptifibatide, 600 mg clopidogrel produced better inhibition than 300 mg clopidogrel at all time points(P< 0.001). Glycoprotein IIb/IIIa(GPIIb/IIIa) blockade was associated with lower cardiac marker release. Active GPIIb/IIIa expression was inhibited most in the groups treated with eptifibatide(P< 0.05). Conclusions -In elective stenting without clopidogrel pretreatment, use of a GPIIb/IIIa inhibitor produces superior platelet inhibition and lower myocardial necrosis compared with high-dose(600 mg) or standard-dose(300 mg) clopidogrel loading alone. In the absence of a GPIIb/IIIa inhibitor, 600 mg clopidogrel provides better platelet inhibition than the standard 300-mg dose. These results require confirmation in a large-scale clinical trial. 展开更多
关键词 依替巴肽 CLEARPlatelets 冠状动脉支架 负荷剂量 预治疗 析因分析 肌坏死 抑制作用 药效学 血细胞计数
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阿司匹林对血小板功能的剂量相关效应评估:来自ASPECT(阿司匹林诱导血小板效应)研究的结果 被引量:1
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作者 Gurbel P.A. Bliden K.P. +1 位作者 DiChiara J. 杜媛 《世界核心医学期刊文摘(心脏病学分册)》 2007年第10期44-45,共2页
背景:阿司匹林的抗血小板作用源于对血小板环氧合酶-1的抑制。然而冠状动脉疾病患者中阿司匹林抵抗的发生率以及阿司匹林剂量对血小板抑制的影响仍有争议。
关键词 阿司匹林 血小板抑制 乙酰水杨酸 血小板 ASPECT 剂量 用药量 功能
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Impact of clopidogrel treatment on platelet function and thrombogenecity in diabetic patients undergoing elective coronary stenting
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作者 Anand Singla Kevin P. Bliden +8 位作者 Young-Hoon Jeong Joseph DiChiara Mark J. Antonino Denny P. Mathew William C. Muse Katrina Abadilla Tania Gesheff Udaya S. Tantry Paul A. Gurbel 《Journal of Diabetes Mellitus》 2012年第2期153-164,共12页
High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in Type II diabetes mellitus (DM) patients undergoing percutaneous coronar... High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in Type II diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to examine the effect of clopidogrel on platelet reactivity, and thrombogenecity between DM and non-DM PCI-treated patients (n = 138). Patients were categorized according to clopidogrel treatment and DM status. Patients received a maintenance-dose clopidogrel of 75 mg/d (C75 group, n = 72) or a 600 mg clopidogrel loading-dose in clopidogrel na?ve patients (C600 group, n = 66). Platelet function was assessed by thrombelastography, flow cytometry, VerifyNowTM aspirin assay and light transmittance aggregometry (LTA). Aspirin response was similar between treatments and DM status. In the C75 group, DM patients had higher 5 and 20 μM ADP-, 2 μg/ml collagen-induced LTA;and p-selectin expression compared to non-DM patients (p ≤ 0.05 for all). DM patients in the C600 group had higher 5 and 20 μM ADP-induced LTA post dosing (p p 12 receptor antagonists. 展开更多
关键词 Diabetes CLOPIDOGREL PLATELET REACTIVITY HYPERCOAGULABILITY
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