This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fredrickson, B. J. Articles by McIntire, L. V. Search for Related Content PubMed PubMed Citation Articles by Fredrickson, B. J. Articles by McIntire, L. V. Related Collections Restenosis Catheter-based coronary interventions: stents Acute coronary syndromes Platelets

(Circulation. 2000;101:1122.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Effects of Abciximab, Ticlopidine, and Combined Abciximab/Ticlopidine Therapy on Platelet and Leukocyte Function in Patients Undergoing Coronary Angioplasty

Becky J. Fredrickson, PhD; Nancy A. Turner, BS; Neal S. Kleiman, MD; Nikki Graziadei, BS; Kelly Maresh, RN; Mary Ann Mascelli, PhD; Mark B. Effron, MD; Larry V. McIntire, PhD

From the Department of Bioengineering, Rice University (B.J.F., N.A.T., L.V.M.); the Department of Medicine, Baylor College of Medicine (N.S.K., N.G., K.M.), Houston, Tex; Eli Lilly & Co (M.B.E.), Indianapolis, Ind; and Centocor, Inc (M.A.M.), Malverne, Pa.

Correspondence to Larry V. McIntire, PhD, Department of Bioengineering, Rice University, PO Box 1892, Houston, TX 77251. E-mail mcintire{at}rice.edu

Background—Abciximab and ticlopidine reduce adverse cardiovascular events after percutaneous transluminal coronary angioplasty (PTCA). The goal of the current study was to determine if combined abciximab/ticlopidine therapy inhibits arterial thrombosis more effectively than either treatment alone. The effect of each therapy on platelet-leukocyte interactions was also investigated.

Methods and Results—Whole blood samples from 14 patients undergoing PTCA who received abciximab therapy, ticlopidine therapy, or both treatments were evaluated using dynamic experimental systems. Mural thrombus formation under arterial shear conditions (1500 s^-1) was determined in a parallel plate flow chamber. Shear-induced platelet aggregation was evaluated using a cone-and-plate viscometer at a shear rate of 3000 s^-1. Of the 3 treatments, combined abciximab/ticlopidine therapy produced the most consistent reduction in shear-induced platelet aggregation and the most prolonged inhibition of mural thrombosis. Three days after PTCA, abciximab/ticlopidine treatment decreased mural thrombus formation to 50% of baseline values. Abciximab treatment alone inhibited mural thrombosis for only 1 day after PTCA, whereas ticlopidine treatment alone had no significant effect. Two hours after PTCA, abciximab therapy significantly decreased the number of circulating platelet-neutrophil aggregates but significantly enhanced P-selectin–mediated leukocyte adhesion on the collagen/von Willebrand factor–platelet surface.

Conclusions—Combined therapy with abciximab and ticlopidine has a prolonged inhibitory effect on mural thrombosis formation relative to either treatment alone. Further, we demonstrated an unexpected effect of abciximab in enhancing P-selectin–mediated leukocyte adhesion.

Key Words: platelets • leukocytes • thrombosis • abciximab • ticlopidine • angioplasty

This article has been cited by other articles:

				H Dai, J Chen, Q Tao, J Zhu, F Zhang, L Zheng, and Y Qiu Effects of diltiazem on platelet activation and cytosolic calcium during percutaneous transluminal coronary angioplasty Postgrad. Med. J., September 1, 2003; 79(935): 522 - 526. [Abstract] [Full Text]

				J. C. Resendiz, S. Feng, G. Ji, K. A. Francis, M. C. Berndt, and M. H. Kroll Purinergic P2Y12 Receptor Blockade Inhibits Shear-Induced Platelet Phosphatidylinositol 3-Kinase Activation Mol. Pharmacol., March 1, 2003; 63(3): 639 - 645. [Abstract] [Full Text] [PDF]

				J.P. Ottervanger, P. Armstrong, E.S. Barnathan, E. Boersma, J.S. Cooper, E.M. Ohman, S. James, E. Topol, L. Wallentin, M.L. Simoons, et al. Long-Term Results After the Glycoprotein IIb/IIIa Inhibitor Abciximab in Unstable Angina: One-Year Survival in the GUSTO IV-ACS (Global Use of Strategies To Open Occluded Coronary Arteries IV--Acute Coronary Syndrome) Trial Circulation, January 28, 2003; 107(3): 437 - 442. [Abstract] [Full Text] [PDF]

				S. P. Setty, S. Salles-Cunha, R. Scissons, G. Begeman, J. Farison, and H. G. Beebe Noninvasive Measurement of Shear Rate in Autologous and Prosthetic Bypass Grafts Vascular and Endovascular Surgery, November 1, 2002; 36(6): 447 - 455. [Abstract] [PDF]

				J. Graff, U. Klinkhardt, V. B. Schini-Kerth, S. Harder, N. Franz, S. Bassus, and C. M. Kirchmaier Close Relationship between the Platelet Activation Marker CD62 and the Granular Release of Platelet-Derived Growth Factor J. Pharmacol. Exp. Ther., March 1, 2002; 300(3): 952 - 957. [Abstract] [Full Text] [PDF]

				N. A. Turner, J. L. Moake, and L. V. McIntire Blockade of adenosine diphosphate receptors P2Y12 and P2Y1 is required to inhibit platelet aggregation in whole blood under flow Blood, December 1, 2001; 98(12): 3340 - 3345. [Abstract] [Full Text] [PDF]

				S. R. Steinhubl, S. G. Ellis, K. Wolski, A. M. Lincoff, and E. J. Topol Ticlopidine Pretreatment Before Coronary Stenting Is Associated With Sustained Decrease in Adverse Cardiac Events : Data From the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting (EPISTENT) Trial Circulation, March 13, 2001; 103(10): 1403 - 1409. [Abstract] [Full Text] [PDF]