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(Circulation. 2000;102:e186.)
© 2000 American Heart Association, Inc.

Correspondence

Attainment and Maintenance of Platelet Inhibition Through Standard Dosing of Abciximab in Patients Undergoing Percutaneous Coronary Intervention

Dean J. Kereiakes, MD

Carl and Edyth Lindner Center for Research and Education, Ohio Heart Health Center, 2123 Auburn Ave, Suite 424, Cincinnati, Ohio 45219

To the Editor:

My colleagues and I previously evaluated the degree of platelet inhibition in patients having percutaneous coronary intervention who were given standard, weight-adjusted abciximab and who were monitored by the point-of-care rapid platelet function assay.^{1 2} The degree of platelet inhibition was assessed from blood samples obtained at baseline (before abciximab) and at 10 minutes and 1, 8, and 24 hours after abciximab bolus administration.^{2 3} Less than 80% platelet inhibition was observed after abciximab bolus in 6.3% and 14.1% of patients at 10 minutes and 8 hours, respectively.

These findings are entirely consistent with the observations of Steinhubl et al,³ and they attest to both the diversity of abciximab-induced platelet inhibition, particularly during the period of intravenous infusion, and the reproducibility of the rapid platelet function assay testing technique across investigative centers. In addition, my group found that the degree of platelet inhibition provided by standard-dose abciximab was similar in diabetics and nondiabetics, men and women, smokers and nonsmokers, and across clinical syndromes (unstable angina versus stable angina versus recent myocardial infarction). This cumulative experience enhances the validity of Steinhubl et al’s report³ and expands the potential utility of this technique.

References

1. Kereiakes DJ, Mueller M, Howard W, et al. Efficacy of abciximab induced platelet blockade using a rapid point of care assay. J Thromb Thrombolysis. 1999;7:265–275.[Medline] [Order article via Infotrieve]
   
2. Kereiakes DJ, Roth EM, Howard W, et al. Efficacy of abciximab-induced platelet blockade using a rapid point of care assay. Circulation. 1998;98:I-251. Abstract.
   
3. Steinhubl SR, Kottke-Marchant K, Moliterno DJ, et al. Attainment and maintenance of platelet inhibition through standard dosing of abciximab in diabetic and nondiabetic patients undergoing percutaneous coronary intervention. Circulation. 1999;100:1977–1982.[Abstract/Free Full Text]
   

Response

Steven R. Steinhubl, MD

Wilford Hall Medical Center, San Antonio, Texas

Kandice Kottke-Marchant, MD, PhD

David J. Moliterno, MD

Monique Rosenthal

Eric J. Topol, MD

A. Michael Lincoff, MD

Cleveland Clinic Foundation, Cleveland, Ohio

Barry S. Coller

Mount Sinai School of Medicine, New York, NY

We would like to acknowledge the important work of Dr Kereiakes and his group in the evaluation of the rapid platelet function assay^R1 ; their article was published after the submission of our manuscript.^R2 As Dr Kereiakes points out, their results mirrored ours in finding that there is substantial interpatient variability in response to standard abciximab dosing, especially during the infusion period, as measured by the rapid platelet function assay. This variability does not seem to be predictable on the basis of any patient, clinical, or hematologic parameters. The clinical significance of this variability is being assessed in the GOLD (Assessing Ultegra [AU]) study, which was recently completed.

References

1. Kereiakes DJ, Mueller M, Howard W, et al. Efficacy of abciximab induced platelet blockade using a rapid point of care assay. J Thromb Thrombolysis. 1999;7:265–275.
   
2. Kottke-Marchant K, Moliterno DJ, et al. Attainment and maintenance of platelet inhibition by standard dosing of abciximab in diabetic and nondiabetic patients undergoing percutaneous coronary intervention. Circulation. 1999;100:1977–1982.
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kereiakes, D. J. Articles by Coller, B. S. Search for Related Content PubMed PubMed Citation Articles by Kereiakes, D. J. Articles by Coller, B. S. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Angioplasty Related Collections Cardiovascular Pharmacology Platelet function inhibitors Catheter-based coronary interventions: stents