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Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study
INTRODUCTION: Approximately one third of all patients with cardiogenic shock suffer from acute kidney injury. Percutaneous coronary intervention, intra-aortic balloon pump, and continuous renal replacement therapy (CRRT) require effective antiplatelet therapy and anticoagulation, resulting in a high...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2008
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575600/ https://www.ncbi.nlm.nih.gov/pubmed/18759963 http://dx.doi.org/10.1186/cc6998 |
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author | Link, Andreas Girndt, Matthias Selejan, Simina Rbah, Ranja Böhm, Michael |
author_facet | Link, Andreas Girndt, Matthias Selejan, Simina Rbah, Ranja Böhm, Michael |
author_sort | Link, Andreas |
collection | PubMed |
description | INTRODUCTION: Approximately one third of all patients with cardiogenic shock suffer from acute kidney injury. Percutaneous coronary intervention, intra-aortic balloon pump, and continuous renal replacement therapy (CRRT) require effective antiplatelet therapy and anticoagulation, resulting in a high risk for platelet loss and bleeding events. The reversible platelet glycoprotein IIb/IIIa receptor inhibitor tirofiban was investigated to preserve platelet number and activation in a prospective open-blinded endpoint evaluation study. METHODS: Forty patients with cardiogenic shock and acute kidney injury requiring CRRT were randomly assigned to two groups receiving unfractioned heparin (UFH) (n = 20) or a combined anticoagulation with UFH and tirofiban (n = 20). The primary endpoint was platelet loss during CRRT. Secondary endpoints were urea reduction, haemofilter life span, bleeding events, and necessity for platelet transfusions. RESULTS: In UFH-treated patients, the percentage of platelet-monocyte aggregates significantly increased (P < 0.001) and consecutively platelet cell count significantly decreased (P < 0.001). In contrast, combined treatment with UFH and tirofiban significantly decreased platelet-monocyte aggregates and platelet numbers (P < 0.001). CONCLUSIONS: This pilot study provides evidence that the use of tirofiban in addition to UFH prevents platelet loss and preserves platelet function in patients with cardiogenic shock and acute kidney injury requiring CRRT. The pathophysiological inhibition of platelet aggregation and platelet-monocyte interaction appears to be causally involved. |
format | Text |
id | pubmed-2575600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-25756002008-10-30 Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study Link, Andreas Girndt, Matthias Selejan, Simina Rbah, Ranja Böhm, Michael Crit Care Research INTRODUCTION: Approximately one third of all patients with cardiogenic shock suffer from acute kidney injury. Percutaneous coronary intervention, intra-aortic balloon pump, and continuous renal replacement therapy (CRRT) require effective antiplatelet therapy and anticoagulation, resulting in a high risk for platelet loss and bleeding events. The reversible platelet glycoprotein IIb/IIIa receptor inhibitor tirofiban was investigated to preserve platelet number and activation in a prospective open-blinded endpoint evaluation study. METHODS: Forty patients with cardiogenic shock and acute kidney injury requiring CRRT were randomly assigned to two groups receiving unfractioned heparin (UFH) (n = 20) or a combined anticoagulation with UFH and tirofiban (n = 20). The primary endpoint was platelet loss during CRRT. Secondary endpoints were urea reduction, haemofilter life span, bleeding events, and necessity for platelet transfusions. RESULTS: In UFH-treated patients, the percentage of platelet-monocyte aggregates significantly increased (P < 0.001) and consecutively platelet cell count significantly decreased (P < 0.001). In contrast, combined treatment with UFH and tirofiban significantly decreased platelet-monocyte aggregates and platelet numbers (P < 0.001). CONCLUSIONS: This pilot study provides evidence that the use of tirofiban in addition to UFH prevents platelet loss and preserves platelet function in patients with cardiogenic shock and acute kidney injury requiring CRRT. The pathophysiological inhibition of platelet aggregation and platelet-monocyte interaction appears to be causally involved. BioMed Central 2008 2008-08-29 /pmc/articles/PMC2575600/ /pubmed/18759963 http://dx.doi.org/10.1186/cc6998 Text en Copyright © 2008 Link et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Link, Andreas Girndt, Matthias Selejan, Simina Rbah, Ranja Böhm, Michael Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
title | Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
title_full | Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
title_fullStr | Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
title_full_unstemmed | Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
title_short | Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
title_sort | tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575600/ https://www.ncbi.nlm.nih.gov/pubmed/18759963 http://dx.doi.org/10.1186/cc6998 |
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