Argatroban anticoagulation in conjunction with glycoprotein IIb/IIIa inhibition in patients undergoing percutaneous coronary intervention: An open-label, nonrandomized pilot study

Ik Kyung Jang, Bruce E. Lewis, William H. Matthai, Neal S. Kleiman

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Background: Argatroban, a direct thrombin inhibitor, blocks clot-bound thrombin more effectively than does heparin. This multicenter, prospective pilot study evaluated the efficacy and safety of argatroban in combination with glycoprotein IIb/IIIa inhibition in patients undergoing percutaneous coronary intervention. Methods: Patients (N = 152) received argatroban as a 250- or 300-μg/kg bolus, followed by a 15-μg/kg/min infusion during percutaneous coronary intervention. An additional 150-μg/kg bolus was administered if activated clotting times 5-15 min after initiating argatroban were <275 s. Abciximab (N = 150) or double-bolus eptifibatide (N = 2) was administered simultaneously. Results: Median activated clotting times at the beginning and end of the procedure were approximately 300 s. The primary efficacy endpoint - a composite of death, myocardial infarction, or urgent revascularization at 30 days - occurred in 4 (2.6%) patients (no death, 4 myocardial infarctions, and 2 revascularizations). Two (1.3%) patients had major bleeding by the Thrombolysis in Myocardial Infarction criteria (1 retroperitoneal, 1 groin hematoma). Conclusions: Argatroban in combination with glycoprotein IIb/IIIa inhibition appears to provide adequate anticoagulation and be well tolerated with an acceptable bleeding risk for patients undergoing percutaneous coronary intervention. Additional studies are warranted.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalJournal of Thrombosis and Thrombolysis
Volume18
Issue number1
DOIs
StatePublished - Aug 2004

Keywords

  • Argatroban
  • Direct thrombin inhibitor
  • Glycoprotein IIb/IIIa inhibition
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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