UNLABELLED: OBJECTIVES The objective of this study was to determine whether adjunctive therapy during percutaneous coronary intervention (PCI) affects markers of systemic inflammation or platelet activation. Despite different mechanisms of action, direct-thrombin inhibition with bivalirudin during PCI provided similar protection from periprocedural and chronic ischemic complications as compared with unfractionated heparin (UFH) plus planned use of GPIIb/IIIa antagonists in the REPLACE-2 and ACUITY trials. METHODS AND RESULTS:Patients undergoing nonurgent PCI of a native coronary artery were randomized to receive adjunctive therapy with bivalirudin or UFH+eptifibatide. Interleukin (IL)-6 and C-reactive protein (CRP) transiently increased in both groups after PCI. In the UFH+eptifibatide, but not the bivalirudin group, myeloperoxidase (MPO) levels were elevated 2.3-fold above baseline (P=0.004) immediately after PCI. In an in vitro assay, heparin and to a lesser extent enoxaparin, but not bivalirudin or eptifibatide, stimulated MPO release from and binding to neutrophils and neutrophil activation. A mouse model of endoluminal femoral artery denudation was used to investigate further the importance of MPO in the context of arterial injury. CONCLUSIONS: Adjuvant therapy during PCI may have undesired effects on neutrophil activation, MPO release, and systemic inflammation.
RCT Entities:
UNLABELLED: OBJECTIVES The objective of this study was to determine whether adjunctive therapy during percutaneous coronary intervention (PCI) affects markers of systemic inflammation or platelet activation. Despite different mechanisms of action, direct-thrombin inhibition with bivalirudin during PCI provided similar protection from periprocedural and chronic ischemic complications as compared with unfractionated heparin (UFH) plus planned use of GPIIb/IIIa antagonists in the REPLACE-2 and ACUITY trials. METHODS AND RESULTS:Patients undergoing nonurgent PCI of a native coronary artery were randomized to receive adjunctive therapy with bivalirudin or UFH+eptifibatide. Interleukin (IL)-6 and C-reactive protein (CRP) transiently increased in both groups after PCI. In the UFH+eptifibatide, but not the bivalirudin group, myeloperoxidase (MPO) levels were elevated 2.3-fold above baseline (P=0.004) immediately after PCI. In an in vitro assay, heparin and to a lesser extent enoxaparin, but not bivalirudin or eptifibatide, stimulated MPO release from and binding to neutrophils and neutrophil activation. A mouse model of endoluminal femoral artery denudation was used to investigate further the importance of MPO in the context of arterial injury. CONCLUSIONS: Adjuvant therapy during PCI may have undesired effects on neutrophil activation, MPO release, and systemic inflammation.
Authors: Charles L Campbell; Steven R Steinhubl; William C Hooper; Joseph Jozic; Susan S Smyth; Debra Bernstein; Christine De Staercke; George Syros; Brian H Negus; Thomas Stuckey; Gregg W Stone; Roxana Mehran; George Dangas Journal: J Thromb Thrombolysis Date: 2011-02 Impact factor: 2.300
Authors: Guohong Li; John M Sanders; Melissa H Bevard; Zhiqi Sun; James W Chumley; Elena V Galkina; Klaus Ley; Ian J Sarembock Journal: Am J Pathol Date: 2008-03-18 Impact factor: 4.307
Authors: Sangeeta R Kashyap; Adriana G Ioachimescu; Heather L Gornik; Thottathil Gopan; Michael B Davidson; Antonie Makdissi; Jennifer Major; Maria Febbraio; Roy L Silverstein Journal: Obesity (Silver Spring) Date: 2009-06-11 Impact factor: 5.002
Authors: Zifang Song; Rong Jin; Shiyong Yu; Joshua J Rivet; Susan S Smyth; Anil Nanda; D Neil Granger; Guohong Li Journal: PLoS One Date: 2011-08-18 Impact factor: 3.240
Authors: Irina V Gorudko; Alexey V Sokolov; Ekaterina V Shamova; Natalia A Grudinina; Elizaveta S Drozd; Ludmila M Shishlo; Daria V Grigorieva; Sergey B Bushuk; Boris A Bushuk; Sergey A Chizhik; Sergey N Cherenkevich; Vadim B Vasilyev; Oleg M Panasenko Journal: Biol Open Date: 2013-07-26 Impact factor: 2.422