Buscar en
Angiología
Toda la web
Inicio Angiología Antagonistas de los receptores plaquetarios GpIIb/IIIa en angiología y cirugía...
Información de la revista
Vol. 59. Núm. 3.
Páginas 207-215 (Enero 2007)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 59. Núm. 3.
Páginas 207-215 (Enero 2007)
Acceso a texto completo
Antagonistas de los receptores plaquetarios GpIIb/IIIa en angiología y cirugía vascular y endovascular
Platelet GpIIb/IIIa receptor antagonists in angiology and vascular and endovascular surgery
Visitas
10170
J.I. Blanes-Mompó
Autor para correspondencia
lochv@telefonica.net

Correspondencia: Servicio de Angiología, Cirugía Vascular y Endovascular. Hospital Universitario Dr. Peset. Avda. Gaspar Aguilar, 90. E-46017 Valencia.
, A. Torres-Blanco
Servicio de Angiología, Cirugía Vascular y Endovascular. Hospital Universitario Dr. Peset. Valencia, España.
Este artículo ha recibido
Información del artículo
Resumen
Introducción

Las plaquetas desempeñan un papel fundamental en la aparición de procesos aterotrombóticos. La lesión endotelial inicia el proceso de adhesión, activación y agregación plaquetaria, que a través de diferentes vías tiene un punto final común, la agregación de las plaquetas entre sí mediante puentes de fibrinógeno unidos a los receptores GpIIb/IIIa activados. Sobre la base de esto, los fármacos ideales en la prevención y tratamiento de las complicaciones aterotrombóticas serían los antagonistas de estos receptores.

Objetivo

Revisar su utilización y efectividad en cirugía vascular y endovascular.

Desarrollo

Los antagonistas de los receptores plaquetarios GpIIb/IIIa, abciximab, eptifibatida y tirofibán se han demostrado efectivos en el síndrome coronario agudo, en la implantación de stents coronarios, en el tratamiento de las trombosis arteriales graves, y en casos concretos de cirugía endovascular infrainguinal y de angio-plastia/stent carotídeo.

Conclusión

El conocimiento de los antagonistas de los receptores plaquetarios GpIIb/IIIa es necesario en angiología y cirugía vascular, ya que pueden ser útiles en el tratamiento de las trombosis arteriales graves y en la implantación de stents infrainguinalesy carotídeos.

Palabras clave:
Antagonistas de los receptores GpIIb/IIIa
Antiagregantes plaquetarios
Plaquetas
Summary
Introduction

Platelets play a fundamental role in the appearance of atherothrombotic processes. The endothelial lesion triggers the process of platelet adhesion, activation and aggregation, which follows different paths but finally comes to the same endpoint, that is, the aggregation of platelets to each other by means of fibrinogen bridges joined to activated GpIIb/IIIa receptors. From this, the ideal drugs for the prevention and treatment of atherothrombotic complications would be the antagonists of these receptors.

Aim

To review their use and effectiveness in Vascular and Endovascular Surgery. Development. The platelet GpIIb/IIIa receptor antagonists abciximab, eptifibatide and tirofiban have proved to be effective in treating acute coronary syndrome, in the placement of coronary stents, in the treatment of severe arterial thromboses and in specific cases of infrainguinal endovascular surgery and carotid stent/angioplasty procedures.

Conclusions

Knowledge of platelet GpIIb/IIIa receptor antagonists is necessary in angiology and vascular surgery, as they can be useful in the treatment of severe arterial thromboses and in the placement of infrainguinal and carotid stents.

Key words:
Antiplatelet drugs
GpIIb/IIIa receptor antagonists
Platelets
El Texto completo está disponible en PDF
Bibliografía
[1.]
Antithrombotic Trialists' Group.
Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.
BMJ, 324 (2002), pp. 71-86
[2.]
Tran H., Anand S..
Oral antiplatelet therapy in cerebrovascular disease, coronary artery disease and peripheral artery disease.
JAMA, 292 (2004), pp. 1867-1874
[3.]
Cassar K., Bachoo P., Brittenden J..
The role of platelets in peripheral vascular disease.
Eur J Vasc Endovasc Surg., 25 (2003), pp. 6-15
[4.]
Shlansky-Goldberg R..
Platelet aggregation inhibitors for use in peripheral vascular interventions: what can we learned from the experience in the coronary arteries?.
J Vasc Interv Radiol., 13 (2002), pp. 229-246
[5.]
Topol E.J., Yadav J.S..
Recognition of the importance of embolization in atherosclerosis vascular disease.
Circulation, 101 (2000), pp. 570-580
[6.]
Coller B.S..
Potential non-glycoprotein IIb/IIIa effects of abciximab.
Am Heart J., 138 (1999), pp. S1-S5
[7.]
Sacrborough R.M., Kleiman N.S., Phillips D.R..
Platelet glycoprotein IIb/IIIa antagonist: what are the relevant issues concerning their pharmacology and clinical use.
Circulation, 100 (1999), pp. 437-444
[8.]
Dyke C.M..
Safety of glycoprotein IIb/IIIa inhibitors: a heart surgeon's perspective.
Am Heart J., 138 (1999), pp. 307-316
[9.]
Chew D.P., Bhatt D.L., Sapp S., Topol E.J..
Increased mortality with oral platelet glycoprotein IIb/IIIa antagonists. A meta-analysis if phase III multicentre randomized trials.
Circulation, 103 (2001), pp. 201-206
[10.]
Topol E., Ferguson J.J., Weisman H.F., Tcheng J.E., Ellis S.G., Kleiman N.S., et al.
Long-term protection from myocardial ischemic events in a randomized trial of brief integrin beta3 blockade with percutaneous coronary intervention. EPIC Investigators Group. Evaluation of platelet IIb/IIIa inhibition for prevention of ischemic complications.
JAMA, 278 (1997), pp. 479-484
[11.]
The EPILOG Investigators.
Platelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization.
N Engl J Med., 336 (1997), pp. 1689-1696
[12.]
The EPISTENT Investigators.
Randomised placebo-controlled and balloon-angioplasty-controlled trial to asses safety of coronary stenting with use of platelet glycoprotein-IIb/IIIa blockade.
Lancet, 352 (1997), pp. 87-92
[13.]
The IMPACT-II Investigators.
Randomised placebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention: IMPACT-II. Integrilin to minimize platelet aggregation and coronary thrombosis-II.
Lancet, 349 (1997), pp. 1422-1428
[14.]
The PURSUIT Investigators.
Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndrome: the PURSUIT Trial Investigators. Platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrilin therapy.
N Engl J Med., 339 (1998), pp. 436-443
[15.]
O'Shea J.C., Hafley G.E., Greenberg S., Hasselblad V., Lorenz T.J., Kitt M.M., et al.
Platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention: The ESPRIT trial: a randomised controlled trial.
JAMA, 285 (2001), pp. 2468-2473
[16.]
The PRISM Investigators.
A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. Platelet receptor inhibition in ischemic syndrome management (PRISM) study.
N Engl J Med., 338 (1998), pp. 1498-1505
[17.]
Tcheng J.E..
Clinical challenges of platelet glycoprotein IIb/IIIa receptor inhibitor therapy: bleeding, reversal, thrombocytopenia, and retreatment.
Am Heart J., 139 (2000), pp. S38-S45
[18.]
Dasgupta H., Blankenship J.C., Word G.C., Frey C.M., Demko S.L., Menapace F.G..
Thrombocytopenia complicating treatment with intravenous glycoprotein IIb/IIIa receptor inhibitors: a pooled analysis.
Am Heart J., 140 (2000), pp. 206-211
[19.]
Madan M., Kereiakes D.J., Hermiller J.B., Rund M.M., Tudor G., Anderson L., et al.
Efficacy of abciximab readministration in coronary intervention.
Am J Cardiol., 85 (2000), pp. 435-440
[20.]
Topol E.J., Easton D., Harrington R.A., Amarenco P., Califf R.M., Graffagnino C., et al.
Randomized, double-blind, placebo-controlled, international trial of the oral IIb/IIIa antagonist lotrafiban in coronary and cerebrovascular disease.
Circulation, 108 (2003), pp. 399-406
[21.]
Cannon C.P..
Overcoming thrombolytic resistance: rationale and initial clinical experience combining thrombolytic therapy and glycoprotein IIb/IIIa receptor inhibition for acute myocardial infarction.
J Am Coll Cardiol., 34 (1999), pp. 1395-1402
[22.]
Topol E.J..
Toward a new frontier in myocardial reperfusion therapy emerging platelet preeminence.
Circulation, 97 (1998), pp. 211-218
[23.]
Berkompas D.C..
Anciximab combined with angioplasty in a patient with renal artery stent subacute thrombosis.
Cathet Cardiovasc Diagn, 45 (1998), pp. 272-274
[24.]
Calais P., Bock K., Herrlinger J.D., Schommer B., Schroder J..
Lysis of an extensive thrombus in the internal carotid artery using a glycoproteincIIb/IIIa receptor antagonist.
Dtsch Med Wochenschr, 126 (2001), pp. 680-683
[25.]
Cannon C.P..
Overcoming thrombolytic resistance: rationale and initial clinical experience combining thrombolytic therapy and glycoprotein IIb/IIIa receptor inhibition for acute myocardial infarction.
J Am Coll Cardiol., 34 (1999), pp. 1395-1402
[26.]
Tepe G., Schott U., Erley C.M., Albes J., Claussen C.D., Duda S.H..
Platelet glycoprotein IIb/IIIa receptor antagonist used in conjunction with thrombolysis for peripheral arterial thrombosis.
AJR Am J Roentgenol., 172 (1999), pp. 1343-1346
[27.]
Scweizer J., Kirsh W., Koch R., Muller A., Gellner G., Forkmann L..
Short and long-term results of abciximab versus aspirin in conjunction with thrombolysis for patients with peripheral occlusive arterial disease and thrombosis.
Angiology, 51 (2000), pp. 913-923
[28.]
Duda S.H., Tepe G., Luz O., Ouriel K., Dietz K., Hahn U., et al.
Abciximab and urokinase alone in the treatment of peripheral artery occlusion: a randomized pilot trial (the PROMPT study).
Radiology, 221 (2001), pp. 689-696
[29.]
Ouriel K., Castañeda F., McNamara T., Swischuk J., Tepe G., Smith J.J., et al.
Reteplase monotherapy and reteplase/abciximab combination therapy in peripheral arterial occlusive disease: results from the RELAX trial.
J Vasc Interv Radiol., 15 (2004), pp. 229-238
[30.]
Schweizer J., Kirch W., Koch R., Muller A., Hellner G., Forkmann L..
Use of abciximab and tirofiban in patients with peripheral arterial occlusive disease and arterial thrombosis.
Angiology, 54 (2003), pp. 155-161
[31.]
Ansel G.M., Silver M.J., Botti C.F. Jr, Rocha-Sing K., Bates M.C., Rosenfield K., et al.
Functional and clinical outcomes of nitinol stenting with and without abciximab for complex superficial femoral artery disease: a randomised trial.
Catheter Cardiovasc Interv, 67 (2006), pp. 288-297
[32.]
Dórffler-Melly J., Mahler F., Do D., Triller J., Baumgartner I..
Adjunctive abciximab improves patency and functional out come in endovascular treatment of femoropopliteal occlusions: Initial experience.
Radiology, 237 (2005), pp. 1103-1109
[33.]
Kapadia S.R., Bajzer C.T., Ziada K.M., Bhatt D.L., Wazni O.M., Silver M.J., et al.
Initial experience of platelet glycoprotein IIb/IIIa inhibition with abciximab during carotid stenting. A safe and effective adjunctive therapy.
Stroke, 32 (2001), pp. 2328-2332
[34.]
Wholey M.H., Wholey M.H., Eles G., Toursakissian B., Bailey S., Jarmolowski C., et al.
Evaluation of glycoprotein IIb/IIIa inhibitors in carotid angioplasty and stenting.
[35.]
Kopp C.W., Steiner S., Nasel C., Seidinger D., Mlekusch I., Lang W., et al.
Abciximab reduces monocyte tissue factor in carotid angioplasty and stenting.
[36.]
Levy E.I., Hopkins I.N..
Utility of abciximab dring carotid stenting when distal protection is contraindicated.
Copyright © 2007. SEACV
Opciones de artículo
Herramientas
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos