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Efectos de la integrelina, un antagonista del receptor de la glicoproteína IIb/IIIa de las plaquetas, en la angina de
S P Schulman1, P J Goldschmidt-Clermont, E J Topol
1Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Md, USA.
Circulation
|November 1, 1996
Resumen
Integrelin redujo significativamente los eventos isquémicos en pacientes con angina inestable en comparación con la aspirina. Este potente inhibidor plaquetario es bien tolerado y efectivo cuando se agrega a la terapia con heparina.
Área de la Ciencia:
- Cardiología Cardiología.
- Farmacología Farmacología.
Sus antecedentes:
- La aspirina es un débil inhibidor de la agregación plaquetaria para la angina inestable.
- La inhibición de la glicoproteína (GP) IIb/IIIa es un objetivo para la terapia antiplaquetaria.
Objetivo del estudio:
- Para evaluar el efecto de Integrelin en la isquemia en la angina inestable.
- Para comparar Integrelin con aspirina en el manejo de eventos isquémicos.
Principales métodos:
- 227 pacientes con angina inestable recibieron heparina y terapia estándar.
- Los pacientes fueron asignados al azar a aspirina más placebo Integrelin, aspirina con placebo más una dosis baja de Integrelin o aspirina con placebo más una dosis alta de Integrelin.
- El monitoreo de Holter evaluó los episodios isquémicos y su duración durante las 24-72 horas del tratamiento.
Principales resultados:
- El grupo de dosis altas de Integrelin tuvo menos (0.24) y más cortos (8.41 min) episodios isquémicos.
- El grupo de aspirina experimentó más (1.0) y más largos (26.2 min) episodios isquémicos (P < .05).
- Integrelin mostró una inhibición de la agregación plaquetaria dependiente de la dosis; no se observó isquemia de rebote ni aumento del sangrado.
Conclusiones:
- Integrelin intravenoso es un potente y reversible inhibidor de la agregación plaquetaria.
- La adición de Integrelin a la heparina reduce los eventos isquémicos en la angina inestable.
- Integrelin es bien tolerado y superior a la aspirina en esta población de pacientes.
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