Relation between inhibition of platelet aggregation and clinical outcomes,☆☆,

https://doi.org/10.1053/hj.1998.v136.93433Get rights and content

Abstract

Am Heart J 1998;136:S43-S50

Section snippets

Measurement of Biological Effect

When treating patients with antithrombotic therapy, it is common to measure some parameter of the hemostatic system to assess the biological effect of the agent. Such assays typically quantitate the ability of the agent to interrupt the hemostatic system. The assumption is made that a certain level of inhibition is desirable in producing a balance between providing efficacy and remaining safe. Examples of this include measurement of the activated partial thromboplastin time and the activated

Summary and Conclusions

Despite a clinical trials experience in excess of 30,000 randomized patients, there is no definitive answer or agreement as to the relation between the level of inhibition of platelet aggregation and clinical outcome. Work with abciximab in the setting of percutaneous intervention would suggest that a level of platelet inhibition in excess of 80% provides the most favorable clinical benefit. Whether this applies to the small molecule inhibitors such as eptifibatide, tirofiban, and lamifiban is

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    From the aDivisions of Cardiology and Hematology, Duke University Medical Center; the bDivision of Cardiology, Baylor College of Medicine.

    ☆☆

    Reprint requests: Robert A. Harrington, MD, Duke Clinical Research Institute, P.O. Box 17969 Durham, NC 27715.

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