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Hamostaseologie 1998; 18(04): 171-179
DOI: 10.1055/s-0038-1655350
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Schattauer GmbH

Glykoprotein-IIb/IIIaAntagonisten

H. Darius
1   II. Medizinische Klinik und Poliklinik (Direktor: Professor Dr. J. Meyer), Johannes-Gutenberg-Universität, Mainz
,
T. Grosser
1   II. Medizinische Klinik und Poliklinik (Direktor: Professor Dr. J. Meyer), Johannes-Gutenberg-Universität, Mainz
› Author Affiliations
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Publication History

Publication Date:
27 June 2018 (online)

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Zusammenfassung

Durch die funktionelle und molekulare Charakterisierung des thrombozytären Fibrinogenrezeptors (Glykoprotein-IIb/IIIa-Rezeptor; Integrin áIIbâ3) konnte die Bedeutung der Fibrinogenbindung für die Thrombozytenaggregation erkannt werden. Dies ist klinisch vor allem beim akuten Koronarsyndrom von Bedeutung. Als erster therapeutisch einsetzbarer Antagonist stand ein blockierendes Fragment eines monoklonalen Antikörpers zur Verfügung (Abciximab), das in verschiedenen Studien mit großem Erfolg bei Koronarinterventionen und bei instabiler Angina pectoris eingesetzt wurde. Durch Therapie der Patienten mit Abciximab konnte die Inzidenz der unerwünschten kardialen Ereignisse hochsignifikant reduziert werden. Synthetische Antagonisten für die intravenöse Anwendung sind ebenfalls mit Erfolg bei instabiler Angina und Koronarinterventionen angewandt worden, und die ersten Verbindungen sind bereits für die Therapie verfügbar. Die initial deutlich erhöhte Blutungsrate der Patienten unter Therapie mit G PI Ib/I I laAntagonisten konnte durch Reduktion der gleichzeitig applizierten Heparindosen deutlich vermindert werden. Andere Indikationen, wie die Behandlung des akuten Myokardinfarktes während einer Rekanalisationstherapie, werden zur Zeit eingehend untersucht. Ebenfalls Gegenstand intensiver klinischer Studien sind die oral resorbierbaren GPIIb/IIIa-Rezeptorantagonisten, die zur Nachbehandlung nach Koronarinterventionen oder akutem Koronarsyndrom entwickelt werden.

Schlüsselwörter

Glykoprotein-IIb/IIIa-Rezeptor - Fibrinogen-Rezeptor - Thrombozyten - akutes Koronarsyndrom
 

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