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Additive effects between platelet concentrates and desmopressin in antagonizing the platelet glycoprotein IIb/IIIa inhibitor eptifibatide
Author(s) -
Reiter Rosemarie,
JilmaStohlawetz Petra,
Horvath Michaela,
Jilma Bernd
Publication year - 2005
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2005.04021.x
Subject(s) - eptifibatide , platelet , medicine , aspirin , apheresis , desmopressin , crossover study , placebo , pharmacology , dose , thromboelastography , anesthesia , percutaneous coronary intervention , myocardial infarction , alternative medicine , pathology
BACKGROUND: Platelet (PLT) glycoprotein (GP) IIb/IIIa receptor antagonists have demonstrated efficacy in decreasing ischemic complications of percutaneous coronary intervention and/or unstable angina. In case of bleeding, the drug can be stopped and PLT transfusions can be given. STUDY DESIGN AND METHODS: This crossover study tested the additive effects of PLT concentrates (PCs) after desmopressin (DDAVP) infusion in antagonizing the anti‐PLT effects of GPIIb/IIIa inhibitors and aspirin. After eptifibatide and aspirin infusion (at standard dosages), 10 healthy volunteers received DDAVP or placebo. Thereafter, increasing amounts of PLTs from fresh single‐donor apheresis concentrates were added in vitro to blood samples of all volunteers to increase PLT counts by 30 × 10 9 , 60 × 10 9 , or 120 × 10 9 per L. RESULTS: Adding platelets in vitro further improved PLT function after DDAVP: it shortened collagen‐adenosine diphosphate closure times (p < 0.01), to normal ranges as measured by the PLT function analyzer (PFA‐100). In contrast, normal PLT function could not be restored even when PLT counts were increased by 50 percent (120 × 10 9 /L) in the placebo group. CONCLUSION: Combined use of PLTs from fresh apheresis PC and DDAVP additively enhances recovery of normal PLT function after eptifibatide infusion. Such a strategy may help to avoid excessive transfusion of PC.