Thromb Haemost 2002; 88(06): 1012-1019
DOI: 10.1055/s-0037-1613348
Involvement of Thrombin Receptors in the Subject-dependent Variability in Ca2+ Signal Generation
Schattauer GmbH

Combined Effects of Eptifibatide and Anticoagulants: Differences between LMWH and UH or rH in Thrombin Generation Inhibition but not in Platelet Aggregation Inhibition

Martin Koestenberger
1   Department of Pediatrics, Haemostasis and Thrombosis, University of Graz, Austria
2   Ludwig Boltzmann Research Institute for Pediatric Haemostasis and Thrombosis, University of Graz, Austria
,
Siegfried Gallistl
1   Department of Pediatrics, Haemostasis and Thrombosis, University of Graz, Austria
2   Ludwig Boltzmann Research Institute for Pediatric Haemostasis and Thrombosis, University of Graz, Austria
,
Gerhard Cvirn
2   Ludwig Boltzmann Research Institute for Pediatric Haemostasis and Thrombosis, University of Graz, Austria
,
Birgit Roschitz
2   Ludwig Boltzmann Research Institute for Pediatric Haemostasis and Thrombosis, University of Graz, Austria
,
Martina Petritsch
2   Ludwig Boltzmann Research Institute for Pediatric Haemostasis and Thrombosis, University of Graz, Austria
,
Bettina Leschnik
1   Department of Pediatrics, Haemostasis and Thrombosis, University of Graz, Austria
,
Wolfgang Muntean
1   Department of Pediatrics, Haemostasis and Thrombosis, University of Graz, Austria
2   Ludwig Boltzmann Research Institute for Pediatric Haemostasis and Thrombosis, University of Graz, Austria
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Publikationsverlauf

Received 02. Juni 2002

Accepted after resubmission 05. August 2002

Publikationsdatum:
09. Dezember 2017 (online)

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Summary

Aim of our study was to investigate effects of eptifibatide and anticoagulants on platelet aggregation and thrombin generation under low and high coagulant challenge in tissue factor-activated platelet rich plasma using a model allowing simultaneous determination of the time course of platelet aggregation and thrombin generation. Eptifibatide exerted a dose-dependent anti-aggregating effect under both high and significantly stronger under low coagulant challenge. Combination of eptifibatide and anticoagulants resulted in significant additive prolongation of the lag phase until the onset of platelet aggregation, more pronounced under low coagulant challenge. Under high, but not under low coagulant challenge combination of eptifibatide and anticoagulants had a significant synergistic inhibitory effect on platelet aggregation. Under low coagulant challenge combination of eptifibatide with LMWH, but not with UH, or rH, resulted in significantly reduced thrombin potential, F 1+2 generation, and FXa formation compared to measurements in the absence of eptifibatide.

We demonstrate a synergistic effect of eptifibatide and anticoagulants on platelet aggregation inhibition and an additional inhibitory effect of LMWH and eptifibatide on thrombin generation. Our results support the notion that combination of eptifibatide and anticoagulants might be beneficial in atherosclerotic disease to palliate the thrombogenic potency of ruptured atherosclerotic plaques.