Role of platelets in restenosis after percutaneous coronary revascularization

被引:93
作者
LeBreton, H
Plow, EF
Topol, EJ
机构
[1] CLEVELAND CLIN FDN, DEPT CARDIOL, CLEVELAND, OH 44195 USA
[2] CLEVELAND CLIN FDN, JOSEPH J JACOBS CTR THROMBOSIS & VASC BIOL, CLEVELAND, OH 44195 USA
关键词
FIBRINOGEN RECEPTOR ANTAGONIST; SMOOTH-MUSCLE CELLS; PLACEBO-CONTROLLED TRIAL; ARG-GLY-ASP; GLYCOPROTEIN-IIB/IIIA ANTAGONISTS; FIBROBLAST GROWTH-FACTOR; DEEP ARTERIAL INJURY; VITRONECTIN RECEPTOR; EXPERIMENTAL ANGIOPLASTY; ENDOTHELIAL-CELLS;
D O I
10.1016/S0735-1097(96)00417-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The role of platelets in the process of restenosis after percutaneous coronary intervention is not fully understood. After vascular injury there is extensive platelet activation, adhesion, aggregation and secretion. Through the liberation of growth factors, such as platelet-derived growth factor, and surface expression of cell adhesion molecules, such as the glycoprotein IIb/IIIa integrin, platelets appear to be a pivotal mediator of the vascular injury response. Experimental models have demonstrated that profound, prolonged thrombocytopenia, or blockade of the IIb/IIIa receptor, may reduce neointimal hyperplasia after arterial balloon injury. However, multiple clinical trials testing conventional or new platelet agents have not yielded any salutary effects. The recent finding that abciximab, a monoclonal antibody fragment directed against IIb/IIIa, reduced clinical restenosis after coronary angioplasty by 26% in patients raises questions about the mechanism of benefit. The alpha(v) beta(3) vitronectin receptor is responsible for binding endothelial cells to platelets, and it also has a key role in modulating smooth muscle cell migration. It is possible that the antibody fragment exerts its effect on restenosis by means of alpha(v) beta(3), because abciximab fully cross reacts to this integrin owing to the shared beta(3) subunit. To date, the other platelet glycoprotein IIb/IIIa inhibitors, including Integrelin, Tirofiban, Lamifiban and Xemilofiban, are specific in binding to this particular integrin. Considerable further study is necessary to unravel the effects of platelets on the restenosis process. (C) 1996 by the American College of Cardiology
引用
收藏
页码:1643 / 1651
页数:9
相关论文
共 107 条
  • [1] INTEGRINS AND OTHER CELL-ADHESION MOLECULES
    ALBELDA, SM
    BUCK, CA
    [J]. FASEB JOURNAL, 1990, 4 (11) : 2868 - 2880
  • [2] LOW-MOLECULAR-WEIGHT, NONPEPTIDE FIBRINOGEN RECEPTOR ANTAGONISTS
    ALIG, L
    EDENHOFER, A
    HADVARY, P
    HURZELER, M
    KNOPP, D
    MULLER, M
    STEINER, B
    TRZECIAK, A
    WELLER, T
    [J]. JOURNAL OF MEDICINAL CHEMISTRY, 1992, 35 (23) : 4393 - 4407
  • [3] PREPARATION, CHARACTERIZATION, AND EVALUATION OF A MONOCLONAL-ANTIBODY AGAINST THE RABBIT PLATELET GLYCOPROTEIN IIB/IIIA IN AN EXPERIMENTAL ANGIOPLASTY MODEL
    AZRIN, MA
    LING, FS
    CHEN, QS
    PAWASHE, A
    MIGLIACCIO, F
    HOMER, R
    TODD, M
    EZEKOWITZ, MD
    [J]. CIRCULATION RESEARCH, 1994, 75 (02) : 268 - 277
  • [4] BADIMON J, 1991, CIRCULAITON S2 4, V84, pA264
  • [5] PHARMACOKINETICS AND PHARMACODYNAMICS OF MK-383, A SELECTIVE NONPEPTIDE PLATELET GLYCOPROTEIN-IIB/IIIA RECEPTOR ANTAGONIST, IN HEALTHY-MEN
    BARRETT, JS
    MURPHY, G
    PEERLINCK, K
    LEPELEIRE, ID
    GOULD, RJ
    PANEBIANCO, D
    HAND, E
    DECKMYN, H
    VERMYLEN, J
    ARNOUT, J
    [J]. CLINICAL PHARMACOLOGY & THERAPEUTICS, 1994, 56 (04) : 377 - 388
  • [6] A PERFUSION CHAMBER DEVELOPED TO INVESTIGATE THROMBUS FORMATION AND SHEAR PROFILES IN FLOWING NATIVE HUMAN BLOOD AT THE APEX OF WELL-DEFINED STENOSES
    BARSTAD, RM
    ROALD, HE
    CUI, YW
    TURITTO, VT
    SAKARIASSEN, KS
    [J]. ARTERIOSCLEROSIS AND THROMBOSIS, 1994, 14 (12): : 1984 - 1991
  • [7] PURIFICATION AND PRELIMINARY CHARACTERIZATION OF THE GLYCOPROTEIN IB COMPLEX IN THE HUMAN-PLATELET MEMBRANE
    BERNDT, MC
    GREGORY, C
    KABRAL, A
    ZOLA, H
    FOURNIER, D
    CASTALDI, PA
    [J]. EUROPEAN JOURNAL OF BIOCHEMISTRY, 1985, 151 (03): : 637 - 649
  • [8] BERTRAND ME, 1990, CIRCULATION, V82, P190
  • [9] STIMULATION OF MIGRATION OF HUMAN AORTIC SMOOTH-MUSCLE CELLS BY VITRONECTIN - IMPLICATIONS FOR ATHEROSCLEROSIS
    BROWN, SL
    LUNDGREN, CH
    NORDT, T
    FUJII, S
    [J]. CARDIOVASCULAR RESEARCH, 1994, 28 (12) : 1815 - 1820
  • [10] BUCHANAN MR, 1993, BLOOD, V81, P3303