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[Eptifibatide blocks the increase in C-reactive protein concentration after coronary angioplasty]
Alvaro Merino Otermin1, Miguel Artaiz Urdaci, Jaume Bergadá García
1Instituto Cardiológico, Clínica Rotger, Palma de Mallorca, Spain. amerino@clinicarotger.es
Insights
Eptifibatide, a drug blocking platelet aggregation, significantly reduced C-reactive protein levels after angioplasty. This suggests arterial thrombosis plays a role in inflammation following interventional procedures.
Area of Science:
- Cardiology
- Biochemistry
- Pharmacology
Background:
- C-reactive protein (CRP) is a marker of inflammation.
- Arterial thrombosis is a common complication of interventional procedures.
- The role of arterial thrombosis in post-procedural inflammation is not fully understood.
Purpose of the Study:
- To evaluate the role of arterial thrombosis in inflammation after interventional procedures.
- To assess the effect of eptifibatide, a platelet GP IIb/IIIa receptor blocker, on C-reactive protein concentrations.
Main Methods:
- A study involving 31 patients undergoing interventional procedures.
- 17 patients received a 12-hour infusion of eptifibatide to block thrombosis.
- C-reactive protein concentrations were measured pre-procedure, post-procedure, and at 6, 24, and 48 hours.
Main Results:
- No significant difference in CRP levels between groups pre- or immediately post-angioplasty.
- The eptifibatide group maintained basal CRP levels 6 hours post-procedure, unlike the control group (p < 0.05).
- CRP levels decreased significantly in the eptifibatide group at 24 hours (p < 0.001) and increased less at 48 hours compared to controls (p < 0.05).
Conclusions:
- Eptifibatide significantly reduced C-reactive protein concentrations after angioplasty.
- Blocking arterial thrombosis with eptifibatide attenuates the inflammatory response post-procedure.
- These findings highlight the contribution of arterial thrombosis to post-interventional inflammation.
Abstract:
We measured C-reactive protein concentrations in 31 patients with interventional procedures after blocking thrombosis in 17 of them by the administration of a 12 hour long infusion of eptifibatide in order to evaluate the role of arterial thrombosis. There were no differences in C reactive protein concentration between the treated and control group pre-angioplasty (0.32 0.4 vs 0.56 0.57 md/dl; p = NS), nor post-angioplasty (0.35 0.42 vs 0.53 0.5 mg/dl, p = Ns). The eptifibatide group maintained basal C reactive protein concentrations 6 hours after the procedure, while the control group had a significant increase (0.43 0.5 vs 1.02 0.89 mg/dl; p < 0.05). There was a decrease in C reactive protein 24 hours after angioplasty in eptifibatide group (0.24 0.27 vs 1.34 0.89 mg/dl; p < 0.001), but it increased again 48 hours after the procedure although to a lesser extent than in the control group (0.57 0.55 vs 2.18 2.1 mg/dl; p < 0.05). Eptifibatide, a synthetic peptide which is a selective blocker of the platelet GP IIb/IIIa receptor significantly reduced C-reactive protein concentration after angioplasty.