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Administration of eptifibatide to acute coronary syndrome patients receiving enoxaparin or unfractionated heparin

Effect on platelet function and thrombus formation

Eli I. Lev, MD^*, David Hasdai, MD^*, Erez Scapa, MD, Ana Tobar, MD, Abid Assali, MD^*, Judith Lahav, PhD, Alexander Battler, MD^*, Juan J. Badimon, PhD^|| and Ran Kornowski, MD^*,*

^* Cardiology Department, Rabin Medical Center, Israel (affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
Department of Medicine "H," Rabin Medical Center, Israel (affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
Pathology Department, Rabin Medical Center, Israel (affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
Coagulation Laboratory, Rabin Medical Center, Israel (affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
^|| Cardiovascular Biology Research Laboratory, the Cardiovascular Institute, Mount Sinai Medical Center, New York, New York, USA

View larger version (27K): [in a new window]   Figure 1 (A) Total thrombus area (µm2) at high shear rate (HSR) and low shear rate (LSR) in the enoxaparin-eptifibatide group, and (B) the UFH-eptifibatide group. Data presented as mean ± SEM. In both groups and at both shear rates, highly significant differences were observed between the baseline value and the post-eptifibatide value (p < 0.0001). However, the reductions achieved in group 1 were significantly higher than those achieved in group 2 (p = 0.01 for inter-group differences at HSR, p = 0.0001 for LSR). Solid bars = baseline; open bars = post-eptifibatide.

View larger version (145K): [in a new window]   Figure 2 Photomicgrographs of total thrombus formation in a representative patient from group 1. (Upper panel) At baseline under enoxaparin treatment. (Lower panel) Combined treatment by enoxaparin and eptifibatide (post-eptifibatide bolus). Staining with combined Masson's trichrome-elastin, 10-fold magnification.