Abstract
The goal of acute stroke therapy is to salvage brain tissue by rapid cerebral artery recanalization to improve microcirculation. A major drawback of fibrinolysis is the activation of platelets leading to a high rate of re-occlusion. Antagonists of the platelet GPIIb/IIIa-receptor inhibit the binding of fibrinogen to platelets counteracting secondary thrombus formation. Also, they were shown to suppress thrombembolus formation and to limit lesion development in cerebral ischemia. We review the literature concerning the use of intravenously administered GPIIb/IIIa-receptor antagonists abciximab, eptifibatide and tirofiban for the treatment of patients with acute ischemic brain infarction. In multicenter, prospective, randomized and placebo-controlled trials abciximab had a higher cerebral bleeding risk, while tirofiban did not increase hemorrhage. When combined with fibrinolysis, abciximab and tirofiban were found to improve cerebral artery recanalization and tissue reperfusion resulting in reduced infarct volumes and improved neurological outcome. Thus, GPIIb/IIIareceptor antagonists have a great potential for the treatment of acute stroke.
Keywords: Stroke, fibrinolysis, reperfusion, hemorrhage, receptor polymorphism
Current Vascular Pharmacology
Title: Platelet GPIIb/IIIa Receptor Antagonists in Human Ischemic Brain Disease
Volume: 6 Issue: 1
Author(s): Rudiger J. Seitz and Mario Siebler
Affiliation:
Keywords: Stroke, fibrinolysis, reperfusion, hemorrhage, receptor polymorphism
Abstract: The goal of acute stroke therapy is to salvage brain tissue by rapid cerebral artery recanalization to improve microcirculation. A major drawback of fibrinolysis is the activation of platelets leading to a high rate of re-occlusion. Antagonists of the platelet GPIIb/IIIa-receptor inhibit the binding of fibrinogen to platelets counteracting secondary thrombus formation. Also, they were shown to suppress thrombembolus formation and to limit lesion development in cerebral ischemia. We review the literature concerning the use of intravenously administered GPIIb/IIIa-receptor antagonists abciximab, eptifibatide and tirofiban for the treatment of patients with acute ischemic brain infarction. In multicenter, prospective, randomized and placebo-controlled trials abciximab had a higher cerebral bleeding risk, while tirofiban did not increase hemorrhage. When combined with fibrinolysis, abciximab and tirofiban were found to improve cerebral artery recanalization and tissue reperfusion resulting in reduced infarct volumes and improved neurological outcome. Thus, GPIIb/IIIareceptor antagonists have a great potential for the treatment of acute stroke.
Export Options
About this article
Cite this article as:
Seitz J. Rudiger and Siebler Mario, Platelet GPIIb/IIIa Receptor Antagonists in Human Ischemic Brain Disease, Current Vascular Pharmacology 2008; 6 (1) . https://dx.doi.org/10.2174/157016108783331303
DOI https://dx.doi.org/10.2174/157016108783331303 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Inflammation and Cancer: In Medio Stat Nano
Current Medicinal Chemistry Recent Patents on Biomedical Applications for the Treatment of Atherosclerosis
Recent Patents on Regenerative Medicine Patent Selections
Recent Patents on Anti-Cancer Drug Discovery Platelet Biomarkers in Tumor Growth
Current Proteomics Clinical Studies with Targeted Toxins in Malignant Glioma
Reviews on Recent Clinical Trials Obesity and Pregnancy
Current Women`s Health Reviews A Novel Functional Approach Toward Identifying Definitive Drug Targets
Current Medicinal Chemistry The First Years of Linezolid Experience in Clinical Practice: A Balance and Future Implications
Anti-Infective Agents in Medicinal Chemistry Molecular Chaperone Disorders: Defective Hsp60 in Neurodegeneration
Current Topics in Medicinal Chemistry Cell Death in Mammalian Development
Current Pharmaceutical Design Recent Applications of DNA Sequencing Technologies in Food, Nutrition and Agriculture
Recent Patents on Food, Nutrition & Agriculture Methylenedioxy- and Ethylenedioxy-Fused Indolocarbazoles: Potent Human Topoisomerase I Inhibitors and Antitumor Agents
Anti-Cancer Agents in Medicinal Chemistry Telomere G-Quadruplex as a Potential Target to Accelerate Telomere Shortening by Expanding the Incomplete End-Replication of Telomere DNA
Current Topics in Medicinal Chemistry Phytosterols and Triterpenoids for Prevention and Treatment of Metabolic-related Liver Diseases and Hepatocellular Carcinoma
Current Pharmaceutical Biotechnology Clinical Implications of Patient-Provider Agreements in Opioid Prescribing
Current Drug Safety Nanocarriers as Prospective Approach in Effective Management of Acne Vulgaris
Micro and Nanosystems New Therapeutic Strategies for Coeliac Disease: Tissue Transglutaminase as a Target
Current Medicinal Chemistry Personalized Therapies in Pediatric Inflammatory and Autoimmune Diseases
Current Pharmaceutical Design Dietary Antioxidants: Immunity and Host Defense
Current Topics in Medicinal Chemistry The Effects of Mindfulness-Based Interventions on Sleep Disturbance: A Meta-Analysis
Adolescent Psychiatry