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Effect of Clopidogrel With and Without Eptifibatide on Tumor Necrosis Factor-Alpha and C-Reactive Protein Release After Elective Stenting

Results From the CLEAR PLATELETS 1b Study

Sinai Center for Thrombosis Research, Baltimore, Maryland.

View larger version (27K): [in this window] [in a new window] [Download PPT slide]   Figure 1 (A) Relative percentage change in adenosine diphosphate (ADP)–induced (5 and 20 µM) platelet aggregation (LTA), P-selectin, and activated glycoprotein (GP) IIb/IIIa expression in 4 treatment groups. The p values compare groups treated with 300-mg versus 600-mg clopidogrel doses. (B) Relative percentage change in plasma tumor necrosis factor (TNF)- and C-reactive protein (CRP) levels in 4 treatment groups. The p values compare groups treated with 300-mg versus 600-mg clopidogrel doses.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Relative percentage change in 5 and 20 µM ADP–induced platelet aggregation, activated GP IIb/IIIa receptor, P-selectin expression, plasma TNF-, and CRP levels in patients treated with clopidogrel alone (open bars) and clopidogrel with eptifibatide (solid bars). Abbreviations as in Figure 1.

View larger version (18K): [in this window] [in a new window] [Download PPT slide]   Figure 3 (A) Relation of maximum creatinine kinase-MB (CK-MB) to post-treatment plasma CRP (mg/l) levels. (B) Relation of necrosis marker release to post-treatment plasma TNF- (ng/ml) levels. NL = normal limit; ULN = upper limit of normal; other abbreviations as in Figure 1.

View larger version (14K): [in this window] [in a new window] [Download PPT slide]   Figure 4 (A) Observed frequency of absolute change in platelet aggregation in each quartile of plasma C-reactive protein (CRP) levels. The p value compares platelet inhibition in patients with the lowest and highest quartiles for CRP. (B) Observed frequency of patients treated with eptifibatide in each quartile of plasma CRP levels. The p values indicate the relation of each quartile to the lowest quartile.