Glykoprotein-IIb/IIIaAntagonisten

H. Darius; T. Grosser

doi:10.1055/s-0038-1655350

Hämostaseologie, Table of Contents

Hamostaseologie 1998; 18(04): 171-179
DOI: 10.1055/s-0038-1655350

Übersichtsarbeiten/Review Articles

Schattauer GmbH

Glykoprotein-IIb/IIIaAntagonisten

H. Darius

¹II. Medizinische Klinik und Poliklinik (Direktor: Professor Dr. J. Meyer), Johannes-Gutenberg-Universität, Mainz

,

T. Grosser

¹II. Medizinische Klinik und Poliklinik (Direktor: Professor Dr. J. Meyer), Johannes-Gutenberg-Universität, Mainz

› Author Affiliations

Abstract

Zusammenfassung

Durch die funktionelle und molekulare Charakterisierung des thrombozytären Fibrinogenrezeptors (Glykoprotein-IIb/IIIa-Rezeptor; Integrin á_IIbâ₃) konnte die Bedeutung der Fibrinogenbindung für die Thrombozytenaggregation erkannt werden. Dies ist klinisch vor allem beim akuten Koronarsyndrom von Bedeutung. Als erster therapeutisch einsetzbarer Antagonist stand ein blockierendes Fragment eines monoklonalen Antikörpers zur Verfügung (Abciximab), das in verschiedenen Studien mit großem Erfolg bei Koronarinterventionen und bei instabiler Angina pectoris eingesetzt wurde. Durch Therapie der Patienten mit Abciximab konnte die Inzidenz der unerwünschten kardialen Ereignisse hochsignifikant reduziert werden. Synthetische Antagonisten für die intravenöse Anwendung sind ebenfalls mit Erfolg bei instabiler Angina und Koronarinterventionen angewandt worden, und die ersten Verbindungen sind bereits für die Therapie verfügbar. Die initial deutlich erhöhte Blutungsrate der Patienten unter Therapie mit G PI Ib/I I laAntagonisten konnte durch Reduktion der gleichzeitig applizierten Heparindosen deutlich vermindert werden. Andere Indikationen, wie die Behandlung des akuten Myokardinfarktes während einer Rekanalisationstherapie, werden zur Zeit eingehend untersucht. Ebenfalls Gegenstand intensiver klinischer Studien sind die oral resorbierbaren GPIIb/IIIa-Rezeptorantagonisten, die zur Nachbehandlung nach Koronarinterventionen oder akutem Koronarsyndrom entwickelt werden.

Schlüsselwörter

Glykoprotein-IIb/IIIa-Rezeptor - Fibrinogen-Rezeptor - Thrombozyten - akutes Koronarsyndrom

Full Text

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