Abciximab as a bridging strategy to overcome morphine-prasugrel interaction in STEMI patients

OBJECTIVE: The present study investigated whether the glycoprotein (GP)IIb/IIIa receptor blocker abciximab might be a successful bridging strategy to achieve adequate levels of platelet inhibition rapidly in cases where prasugrel is used in morphine‐pretreated ST‐elevation myocardial infarction (STEMI) patients. METHODS: In a prospective observational cohort study, 32 patients presenting with STEMI were given prasugrel at a loading dose of 60 mg. Patients were stratified into four groups, according to morphine and/or abciximab use. Adenosine diphosphate (ADP)‐induced platelet aggregation was measured at four time points: at baseline, and at 2 h, 1 day and 2 days after prasugrel loading. RESULTS: Morphine use was associated with a three‐fold higher level of ADP‐induced platelet aggregation 2 h after prasugrel loading compared with no morphine/no abciximab (P = 0.019). However, when abciximab was infused in the catheterization laboratory, the effect of morphine on ADP‐induced platelet aggregation disappeared (P = 0.884). This interaction was also seen in the presence of high on‐treatment platelet reactivity (HTPR) at 2 h; while HTPR was seen in 88% of morphine users/no abciximab users, it was found in only 17–20% in the three other groups (P = 0.003). The effect of morphine disappeared by day 1 – 2. CONCLUSION: The infusion of the GPIIb/IIIa receptor blocker abciximab allows immediate and efficient platelet inhibition in STEMI patients concomitantly receiving the oral ADP receptor blocker prasugrel and morphine

PUMA, antiProton unstable matter annihilation

International audiencePUMA, antiProton Unstable Matter Annihilation, is a nuclear-physics experiment at CERN aiming at probing the surface properties of stable and rare isotopes by use of low-energy antiprotons. Low-energy antiprotons offer a very unique sensitivity to the neutron and proton densities at the annihilation site, i.e. in the tail of the nuclear density. Today, no facility provides a collider of low-energy radioactive ions and low-energy antiprotons: while not being a collider experiment, PUMA aims at transporting one billion antiprotons from ELENA, the Extra-Low-ENergy Antiproton ring, to ISOLDE, the rare-isotope beam facility of CERN. PUMA will enable the capture of low-energy antiprotons by short-lived nuclei and the measurement of the emitted radiations. In this way, PUMA will give access to the so-far largely unexplored isospin composition of the nuclear-radial-density tail of radioactive nuclei. The motivations, concept and current status of the PUMA experiment are presented