血小板グリコプロテインIIb/IIIa受容体の抗体であるインテグレリンの作用,不安定な胸痛. ランダム化された多センター試験
S P Schulman1, P J Goldschmidt-Clermont, E J Topol
1Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Md, USA.
Circulation
|November 1, 1996
まとめ
インテグレリンは,アスピリンと比較して,不安定な胸痛患者における不血症イベントを著しく減少させました. この強力な血小板阻害剤は,ヘパリン療法に添加されると,よく耐受され,有効です.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- アスピリンは,不安定な心痛のために弱い血小板集積阻害剤です.
- グリコタンパク質 (GP) IIb/IIIaの抑制は,抗血小板治療の標的である.
研究 の 目的:
- 不安定性 angina の ischemia にインテグレリンの効果を評価する.
- インテグレリンとアスピリンを比較して,不血症イベントの管理を図る.
主な方法:
- 227人の不安定なアンギナ患者はヘパリンと標準療法を受けた.
- 患者はランダムにアスピリンとプラセボインテグレーリン,プラセボインテグレーリンと低用量インテグレーリン,またはプラセボインテグレーリンと高用量インテグレーリンに分けられた.
- ホルターモニタリングは,治療の24-72時間間の不血症エピソードと持続時間を評価しました.
主要な成果:
- 高用量インテグレリン群は,より少ない (0.24) とより短い (8.41分) の不血症エピソードがありました.
- アスピリン群は,より多く (1.0) とより長く (26.2分) の不血症エピソード (P < .05) を経験した.
- インテグレリンは,血小板集約の投与量依存的阻害を示し,リバウンドイシュケミアや出血の増加は観察されなかった.
結論:
- 静脈注射インテグレリンは,強力で,逆戻り可能な血小板凝集阻害剤です.
- ヘパリンにインテグレリンを添加すると,不安定性 angina の場合の缺血性イベントが減少します.
- インテグレリンは,この患者集団において,アスピリンに優れ,よく耐えます.
関連する概念動画
Intracellular Signaling Affects Focal Adhesions
Integrins act both as extracellular input receivers and as intracellular processing activators. As their name suggests, integrins are entirely integrated into the membrane structure. Their hydrophobic membrane-spanning regions interact with the phospholipid bilayer's hydrophobic region. These membrane receptors provide extracellular attachment sites for effectors like hormones and growth factors. They activate intracellular response cascades when their effectors are bound and active.
Some...
Some...
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
Angina II: Classification
Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
Angina IV: Management
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...


