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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Br+J+Clin+Pharmacol 2016 ; 82 (5): 1343-50 Nephropedia Template TP
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Abciximab as a bridging strategy to overcome morphine?prasugrel interaction in STEMI patients #MMPMID27366874
Siller?Matula JM; Specht S; Kubica J; Alexopoulos D; De Caterina R; Hobl E; Jilma B; Christ G; Lang IM
Br J Clin Pharmacol 2016[Nov]; 82 (5): 1343-50 PMID27366874show ga
Objective: The present study investigated whether the glycoprotein (GP)IIb/IIIa receptor blocker abciximab might be a successful bridging strategy to achieve adequate levels of platelet inhibition rapidly in cases where prasugrel is used in morphine?pretreated ST?elevation myocardial infarction (STEMI) patients. Methods: In a prospective observational cohort study, 32 patients presenting with STEMI were given prasugrel at a loading dose of 60 mg. Patients were stratified into four groups, according to morphine and/or abciximab use. Adenosine diphosphate (ADP)?induced platelet aggregation was measured at four time points: at baseline, and at 2 h, 1 day and 2 days after prasugrel loading. Results: Morphine use was associated with a three?fold higher level of ADP?induced platelet aggregation 2 h after prasugrel loading compared with no morphine/no abciximab (P = 0.019). However, when abciximab was infused in the catheterization laboratory, the effect of morphine on ADP?induced platelet aggregation disappeared (P = 0.884). This interaction was also seen in the presence of high on?treatment platelet reactivity (HTPR) at 2 h; while HTPR was seen in 88% of morphine users/no abciximab users, it was found in only 17?20% in the three other groups (P = 0.003). The effect of morphine disappeared by day 1 ? 2. Conclusion: The infusion of the GPIIb/IIIa receptor blocker abciximab allows immediate and efficient platelet inhibition in STEMI patients concomitantly receiving the oral ADP receptor blocker prasugrel and morphine.