Antiplatelet drugs and generation of thrombin in clotting blood

Szczeklik, Andrzej; Krzanowski, Marek; Góra, Paweł; Radwan, J

doi:10.1182/blood.v80.8.2006.bloodjournal8082006

Cited by 33 publications

(5 citation statements)

References 23 publications

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“…21 In addition to its anti-inflammatory effects and its impact on platelet inhibition, aspirin reduces thrombin levels and factor XIII activation. 22 These characteristics might explain why it is effective for preventing vascular access failure.…”

Section: Discussionmentioning

confidence: 99%

Preventing arteriovenous shunt failure in hemodialysis patients: a population‐based cohort study

Fan

Lee

Liu

et al. 2019

Journal of Thrombosis and Haemostasis

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Uncertainty remains about antiplatelets for vascular access patency in hemodialysis patients. 95 971 people under hemodialysis were followed in a claims database in Taiwan. Aspirin reduced vascular access failure rate and did not increase major bleeding rate. Clopidogrel, Aggrenox, and warfarin might increase major bleeding rate. Summary BackgroundDialysis adequacy is a major determinant of survival for patients with end‐stage renal disease. Good vascular access is essential to achieve adequate dialysis. ObjectivesThis study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. Patients and methodsWe studied patients with end‐stage renal disease registered in the Taiwan National Health Insurance program from 1 January 1997 to 31 December 2012. A total of 95 971 patients were enrolled in our study. Vascular access dysfunction was defined as the need for thrombectomy or percutaneous angioplasty. Major bleeding was defined as emergency department visits or hospitalization with a primary diagnosis of gastrointestinal bleeding or intracerebral hemorrhage. The adjusted odds ratios between person‐quarters with or without antiplatelet or oral anticoagulant use were calculated using a generalized estimating equation. ResultsThe odds ratio of vascular access failure was 0.21 (0.11–0.39) for aspirin, 0.76 (0.74–0.79) for clopidogrel, 0.67 (0.59–0.77) for dipyridamole, 0.67 (0.53–0.86) for Aggrenox and 0.96 (0.90–1.03) for warfarin. The highest odds ratio for intracerebral hemorrhage was 5.33 (1.25–22.72) in younger patients using Aggrenox. The highest odds ratio for gastrointestinal bleeding was 1.34 (1.10–1.64) for clopidogrel. ConclusionAntiplatelet agents, but not warfarin, might reduce the vascular access thrombosis rate. The gastrointestinal bleeding rate was increased in the group using clopidogrel. Aggrenox should be used with caution in young individuals because it might increase the rate of intracerebral hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Preventing arteriovenous shunt failure in hemodialysis patients: a population‐based cohort study

Fan

Lee

Liu

et al. 2019

Journal of Thrombosis and Haemostasis

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“…Aspirin influences various targets to alter the production of venous thrombus, primarily by preventing the synthesis of thromboxane and reducing thrombin production, thus reducing platelet aggregation at antiplatelet dosages [69][70][71].…”

Section: Aspirin In Venous Thromboembolism (Vte)mentioning

confidence: 99%

Pharmacogenetics and Pharmacogenomics Impact on Aspirin Response

Aftab Siddiqui,

Jain,

Usmani

et al. 2024

Pharmacogenomics and Pharmacogenetics in Drug Therapy

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Aspirin, or Acetylsalicylic acid (ASA), is renowned for its pain-relieving and anti-inflammatory properties. Recent insights have illuminated its mechanisms and potential applications. Notably, low-dose aspirin reduces heart attack and stroke risks, particularly in high-risk individuals, yet optimal dosing remains under investigation. Another area explores aspirin’s potential in cancer prevention, especially for colon and gastrointestinal cancers, along with emerging roles against conditions like Alzheimer’s, diabetes, and pre-eclampsia. Aspirin’s benefits extend to kidney disease and COVID-19 research due to its anti-inflammatory actions. Stem cell effects are diverse; while enhancing hematopoietic stem cells aids bone marrow transplants, it may inhibit embryonic stem cells in specific contexts. However, challenges encompass resistance, allergies, gastrointestinal effects, and pediatric Reye’s syndrome. Pharmacogenetic studies illuminate how genetic variations impact aspirin metabolism, with enzymes like CYP2C9 and CYP2C19 affecting clearance rates, and markers such as P2RY12 and COX-1 influencing antiplatelet responses. Customized aspirin therapy, guided by genetic profiles, optimizes benefits and minimizes risks. This research underpins personalized medicine, empowering clinicians to enhance treatment precision, efficacy, and safety. As aspirin’s complex advantages and challenges continue to unfold, refined therapeutic strategies will emerge.

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“…Nonetheless, several studies indicate that these drugs exert antithrombotic effects that are unrelated to inhibition of ADPor TXA 2 -induced platelet aggregation. [31][32][33] Recent findings suggest that 12-hydroxyleicosatetraenoic acid, a procoagulant (tissue factor release) and proaggregatory eicosanoid that is generated alongside TXA 2 from arachidonic acid-stimulated platelets, may play a significant role in variable sensitivity to aspirin. 34 Intake of aspirin significantly delayed and inhibited thrombin generation in native thromboplastin-activated blood, whereas it had no such effect in citrated plasma.…”

Section: Effect Of Anticoagulation On Thrombinmentioning

confidence: 99%