Pharmacologic inhibition of platelet vWF-GPIbα interaction prevents coronary artery thrombosis

James K. Hennan; Robert E. Swillo; Gwen A. Morgan; Courtney E. Leik; Jonathan M. Brooks; Gray D. Shaw; Robert G. Schaub; David L. Crandall; George P. Vlasuk

doi:10.1160/TH05-09-0640

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2006; 95(03): 469-475
DOI: 10.1160/TH05-09-0640

Platelets and Blood Cells

Schattauer GmbH

Pharmacologic inhibition of platelet vWF-GPIbα interaction prevents coronary artery thrombosis

James K. Hennan

¹Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania

,

Robert E. Swillo

¹Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania

,

Gwen A. Morgan

¹Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania

,

Courtney E. Leik

¹Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania

,

Jonathan M. Brooks

^*Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania, Cambridge, Massachussetts, USA

,

Gray D. Shaw

^*Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania, Cambridge, Massachussetts, USA

,

Robert G. Schaub

^*Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania, Cambridge, Massachussetts, USA

,

David L. Crandall

¹Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania

,

George P. Vlasuk

^*Cardiovascular and Metabolic Disease Research, Wyeth Research, Collegeville, Pennsylvania, Cambridge, Massachussetts, USA

› Institutsangaben

Abstract

Summary

Under high shear arterial blood flow von Willebrand Factor (vWF) binds the platelet receptor glycoprotein (GP) Ibα, leading to platelet adhesion, activation and thrombosis. Blockade of vWF-GPIbα interactions by GPG-290 was investigated in a canine model of coronary artery thrombosis alone and in combination with clopidogrel. GPG-290 (100 µg/kg, n=6; 500 µg/kg, n=6) prolonged time to thrombotic occlusion (TTO) to 105±34 and 156±23 (p<0.05) min, respectively compared to the saline treated control group (32±6min, n=6). Patency of the injured vessel was sustained in 1/6 (100µg/kg) and 3/6 vessels (500 µg/kg) 4 hours after injury, in contrast to 0/6 in the control group. There was an increase in bleeding after the 500 µg/kg dose, but only at the 1 hr time point. Clopidogrel was studied in two dosing regimens representing either a clinical pretreatment regimen (PTR) of 4.3 mg/kg on day –2 followed by 1.1 mg/kg daily for2 days prior to the procedure or pre-procedural loading dose regimen (LDR) of 4.3 mg/kg 3 hr pre-procedure. The PTR and LDR clopidogrel treatments prolonged TTO to 98.2±30.0 min and 136.1±39.5 min (p<0.05), and sustained patency in 1/6 and 4/8 vessels, respectively. However, template bleeding time in the LDR clopidogrel group was sustained higher than the control group. The combination of PTR clopidogrel and GPG-290 (100 µg/kg) prolonged TTO equivalent to LDR clopidogrel alone (141.4±35.1 min) and sustained patency in 3/7 dogs, without increased bleeding while LDR clopidogrel combined with 100 µg/kg GPG-290 prevented occlusion in 5/8 dogs and further prolonged TTO (173.5±32.6 min) but was associated with increased bleeding compared to control. GPG-290 is an antithrombotic agent that may be combined with lower doses of clopidogrel to yield similar antithrombotic efficacy as higher loading doses.

Keywords

Glycoprotein (GP) Ibα - platelet adhesion - platelet agglutination - thrombosis - von Willebrand factor (vWF)

Volltext

Referenzen

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