{"title":"两种不同糖蛋白血小板IIb/IIIa抑制剂对颅内管道分流植入患者临床终点的影响","authors":"Qiao Deng, Shichao Zhang, Mingzhou Li, Guozhong Zhang, Wenfeng Feng","doi":"10.1016/j.jimed.2020.08.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoprotein IIb/IIIa antagonists (GPI) eptifibatide and tirofiban.</p></div><div><h3>Methods</h3><p>Retrospective analysis of relevant data of patients using GPIs combined with oral antiplatelet therapy in Nanfang Hospital of Southern Medical University from December 2017 to December 2019. The study was approved by the ethics Committee of Nanfang Hospital of Southern Medical University. According to the random use of GPIs drugs, they were assigned to the eptifibatide group and tirofiban group. Basic data, platelet inhibition rates at baseline, 24h and 72h after administration, short-term major adverse cerebrovascular events, and bleeding complications were compared between the two groups.</p></div><div><h3>Results</h3><p>A total of 47 patients were included in this study, including 24 patients in eptifibatide group and 23 patients in tirofiban group. There was no significant difference in average age (53.75 <em>vs</em>. 53.91 years) and body mass index (BMI) (24.39 <em>vs</em>. 22.73 kg/m2) between eptifibatide group and tirofiban group. There was no significant difference in coagulation factor function (R), fibrinogen function (K), fibrinolysis function (EPL), comprehensive coagulation index (Cl), arachidonic acid pathway inhibition rate (AA%) and adenosine diphosphate inhibition rate (ADP%). However, the baseline level of residual platelet function MA (ADP) in eptifibatide group was significantly higher than that in tirofiban group (50.79 <em>vs</em>. 35.29 mm, P = 0.0026). There was a statistical difference in the platelet aggregation function MA (65.38 <em>vs</em>. 62.54 mm, p = 0.0442), the rate of spontaneous hemorrhagic stroke (4.3% <em>vs</em>. 0%) and the rate of asymptomatic minor bleeding (26.08% <em>vs</em>. 4.1%) in the two groups (P < 0.05).</p></div><div><h3>Conclusion</h3><p>Both eptifibatide and tirofiban can effectively inhibit platelets, but the effect of etifeptide is better than that of tirofiban in preventing intracranial microhemorrhage and asymptomatic cerebral infarction.</p></div>","PeriodicalId":33533,"journal":{"name":"Journal of Interventional Medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jimed.2020.08.005","citationCount":"0","resultStr":"{\"title\":\"Effects of two different glycoprotein platelet IIb/IIIa inhibitors and the clinical endpoints in patients with intracranial Pipeline flow diverter implant\",\"authors\":\"Qiao Deng, Shichao Zhang, Mingzhou Li, Guozhong Zhang, Wenfeng Feng\",\"doi\":\"10.1016/j.jimed.2020.08.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoprotein IIb/IIIa antagonists (GPI) eptifibatide and tirofiban.</p></div><div><h3>Methods</h3><p>Retrospective analysis of relevant data of patients using GPIs combined with oral antiplatelet therapy in Nanfang Hospital of Southern Medical University from December 2017 to December 2019. The study was approved by the ethics Committee of Nanfang Hospital of Southern Medical University. According to the random use of GPIs drugs, they were assigned to the eptifibatide group and tirofiban group. Basic data, platelet inhibition rates at baseline, 24h and 72h after administration, short-term major adverse cerebrovascular events, and bleeding complications were compared between the two groups.</p></div><div><h3>Results</h3><p>A total of 47 patients were included in this study, including 24 patients in eptifibatide group and 23 patients in tirofiban group. There was no significant difference in average age (53.75 <em>vs</em>. 53.91 years) and body mass index (BMI) (24.39 <em>vs</em>. 22.73 kg/m2) between eptifibatide group and tirofiban group. There was no significant difference in coagulation factor function (R), fibrinogen function (K), fibrinolysis function (EPL), comprehensive coagulation index (Cl), arachidonic acid pathway inhibition rate (AA%) and adenosine diphosphate inhibition rate (ADP%). However, the baseline level of residual platelet function MA (ADP) in eptifibatide group was significantly higher than that in tirofiban group (50.79 <em>vs</em>. 35.29 mm, P = 0.0026). There was a statistical difference in the platelet aggregation function MA (65.38 <em>vs</em>. 62.54 mm, p = 0.0442), the rate of spontaneous hemorrhagic stroke (4.3% <em>vs</em>. 0%) and the rate of asymptomatic minor bleeding (26.08% <em>vs</em>. 4.1%) in the two groups (P < 0.05).</p></div><div><h3>Conclusion</h3><p>Both eptifibatide and tirofiban can effectively inhibit platelets, but the effect of etifeptide is better than that of tirofiban in preventing intracranial microhemorrhage and asymptomatic cerebral infarction.</p></div>\",\"PeriodicalId\":33533,\"journal\":{\"name\":\"Journal of Interventional Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.jimed.2020.08.005\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Interventional Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2096360220300533\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2096360220300533","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的比较糖蛋白IIb/IIIa拮抗剂(GPI)、依替巴肽和替罗非班对管道治疗颅内动脉瘤的抗血小板效果和主要脑血管不良事件的影响。方法回顾性分析南方医科大学南方医院2017年12月至2019年12月GPIs联合口服抗血小板治疗患者的相关资料。本研究经南方医科大学南方医院伦理委员会批准。根据GPIs药物的随机使用情况分为依替巴肽组和替罗非班组。比较两组基本数据、给药后基线、24h、72h血小板抑制率、短期主要脑血管不良事件、出血并发症。结果本研究共纳入47例患者,其中依替巴肽组24例,替罗非班组23例。依替非班组和替罗非班组患者的平均年龄(53.75 vs 53.91岁)和体重指数(BMI) (24.39 vs 22.73 kg/m2)差异无统计学意义。凝血因子功能(R)、纤维蛋白原功能(K)、纤维蛋白溶解功能(EPL)、综合凝血指数(Cl)、花生四烯酸途径抑制率(AA%)和二磷酸腺苷抑制率(ADP%)差异均无统计学意义。但依替巴肽组的剩余血小板功能MA (ADP)基线水平显著高于替罗非班组(50.79 vs. 35.29 mm, P = 0.0026)。两组患者血小板聚集功能MA (65.38 vs. 62.54 mm, p = 0.0442)、自发性出血性卒中发生率(4.3% vs. 0%)、无症状轻微出血发生率(26.08% vs. 4.1%)差异有统计学意义(p <0.05)。结论依替巴肽和替罗非班均能有效抑制血小板,但在预防颅内微出血和无症状脑梗死方面,依替巴肽的效果优于替罗非班。
Effects of two different glycoprotein platelet IIb/IIIa inhibitors and the clinical endpoints in patients with intracranial Pipeline flow diverter implant
Objective
To compare the antiplatelet effect and major adverse cerebrovascular events of Pipeline for intracranial aneurysms using glycoprotein IIb/IIIa antagonists (GPI) eptifibatide and tirofiban.
Methods
Retrospective analysis of relevant data of patients using GPIs combined with oral antiplatelet therapy in Nanfang Hospital of Southern Medical University from December 2017 to December 2019. The study was approved by the ethics Committee of Nanfang Hospital of Southern Medical University. According to the random use of GPIs drugs, they were assigned to the eptifibatide group and tirofiban group. Basic data, platelet inhibition rates at baseline, 24h and 72h after administration, short-term major adverse cerebrovascular events, and bleeding complications were compared between the two groups.
Results
A total of 47 patients were included in this study, including 24 patients in eptifibatide group and 23 patients in tirofiban group. There was no significant difference in average age (53.75 vs. 53.91 years) and body mass index (BMI) (24.39 vs. 22.73 kg/m2) between eptifibatide group and tirofiban group. There was no significant difference in coagulation factor function (R), fibrinogen function (K), fibrinolysis function (EPL), comprehensive coagulation index (Cl), arachidonic acid pathway inhibition rate (AA%) and adenosine diphosphate inhibition rate (ADP%). However, the baseline level of residual platelet function MA (ADP) in eptifibatide group was significantly higher than that in tirofiban group (50.79 vs. 35.29 mm, P = 0.0026). There was a statistical difference in the platelet aggregation function MA (65.38 vs. 62.54 mm, p = 0.0442), the rate of spontaneous hemorrhagic stroke (4.3% vs. 0%) and the rate of asymptomatic minor bleeding (26.08% vs. 4.1%) in the two groups (P < 0.05).
Conclusion
Both eptifibatide and tirofiban can effectively inhibit platelets, but the effect of etifeptide is better than that of tirofiban in preventing intracranial microhemorrhage and asymptomatic cerebral infarction.