Relation between impaired antiplatelet response to clopidogrel and possible pleiotropic effects

Małek, Łukasz A.; Grabowski, Marcin; Śpiewak, Mateusz; Filipiak‬, Krzysztof J.; Szpotańska, Monika; Imiela, Tomasz; Huczek, Zenon; Bobilewicz, D; Opolski, Grzegorz

doi:10.1007/s11239-007-0026-8

Cited by 13 publications

(6 citation statements)

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“…Price et al observed no apparent benefit of a higher dose of clopidogrel (150 vs. 75 mg) in patients with HTPR ( 7 ). Moreover, a study conducted to demonstrate the potential additive predictive value of several platelet tests in the assessment of risk and/or recurrence of ischemic events concluded that platelet tests contributed a comparatively minor additive value to ischemic risk assessment in contrast to clinical and angiographic risk models ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions

et al. 2016

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Objective:This study attempted to fill the gaps in evidence related to response to clopidogrel treatment in the Turkish population. The study aimed to determine the prevalence, associated risk factors, and clinical outcomes of high on-treatment platelet reactivity (HTPR) of clopidogrel in patients undergoing percutaneous coronary intervention (PCI) in a tertiary cardiovascular hospital in Turkey.Methods:In this prospective studied a total of 1.238 patients undergoing PCI were included in the present study. Blood samples were analyzed using a Multiplate analyzer. All patients were examined in the outpatient clinics at the end of the first and sixth months for recording drug therapy compliance and study endpoints.Results:Among the study population, 324 (30.2%) patients were found to have HTPR (mean age 58.03±11.88 years, 71.7% men). The incidence of HTPR was higher amongst females than amongst males (38.3% vs. 27%, p=0.010). Hypertension and diabetes mellitus were more frequently observed in the HTPR group (57.7% vs. 48.7%, p=0.004; 35% vs. 29.1%, p=0.040, respectively). When the recorded data were analyzed using multinomial regression analysis, hypertension, hemoglobin level, platelet, lymphocyte, and eosinophil count were independently associated with HTPR.Conclusion:On the basis of the results obtained from our study, we conclude that 30.2% of the Turkish population has HTPR. Our results also led us to believe that hypertension is an associated risk factor and decreased hemoglobin level as well as increased platelet counts are laboratory parameters that are strongly associated with the presence of HTPR. However, no differences were observed with regard to cardiovascular mortality and stent thrombosis. (Anatol J Cardiol 2016; 16: 967-73)

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Section: Discussionmentioning

confidence: 99%

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions

et al. 2016

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“…In ACS patients undergoing PCI, hsCRP increased significantly at day 5 in clopidogrel naïve patients, but was reduced in patients on clopidogrel (Vivekananthan et al, ). Similarly, in low clopidogrel responders, hsCRP increased 7 days post PCI while in high responders, hsCRP remained within the reference intervals (Malek et al, ). In patients receiving long‐term clopidogrel therapy compared with the clopidogrel‐naive group, lower levels of selected inflammation markers (IL, TNF‐α and hsCRP) were achieved (Antonino et al, ).…”

Section: Effects On Inflammationmentioning

confidence: 94%

Effects of P2Y₁₂ receptor antagonists beyond platelet inhibition – comparison of ticagrelor with thienopyridines

Nylander

Schulz

2016

British J Pharmacology

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The effect and clinical benefit of P2Y 12 receptor antagonists may not be limited to platelet inhibition and the prevention of arterial thrombus formation. Potential additional effects include reduction of the pro-inflammatory role of activated platelets and effects related to P2Y 12 receptor inhibition on other cells apart from platelets. P2Y 12 receptor antagonists, thienopyridines and ticagrelor, differ in their mode of action being prodrugs instead of direct acting and irreversibly instead of reversibly binding to P2Y 12 . These key differences may provide different potential when it comes to additional effects. In addition to P2Y 12 receptor blockade, ticagrelor is unique in having the only well-documented additional target of inhibition, the equilibrative nucleoside transporter 1. The current review will address the effects of P2Y 12 receptor antagonists beyond platelets and the protection against arterial thrombosis. The discussion will include the potential for thienopyridines and ticagrelor to mediate anti-inflammatory effects, to conserve vascular function, to affect atherosclerosis, to provide cardioprotection and to induce dyspnea. Abbreviations

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“…One of the other medications of some significant interest within the PFA-100 story is clopidogrel. The PFA-100 appears to be only mildly sensitive to clopidogrel, 99,[113][114][115][116][117][118][119][120][121][122][123][124][125][126][127][128][129] although several studies have shown clopidogrel to potentiate the effects of aspirin or other drugs on the PFA-100 CT and/or time dependence for clopidogrel sensitivity.…”

Section: Sensitivity Of the Pfa-100 To Clopidogrelmentioning

confidence: 99%

Clinical Utility of the PFA-100

Favaloro

2008

Semin Thromb Hemost

288

285

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Relation between impaired antiplatelet response to clopidogrel and possible pleiotropic effects

Abstract: Impaired antiplatelet response to clopidogrel but not to aspirin may contribute to smaller anti-inflammatory response in patients with ST-elevation myocardial infarction.

Cited by 13 publications

References 20 publications

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions

Effects of P2Y₁₂ receptor antagonists beyond platelet inhibition – comparison of ticagrelor with thienopyridines

Clinical Utility of the PFA-100

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Relation between impaired antiplatelet response to clopidogrel and possible pleiotropic effects

Abstract: Impaired antiplatelet response to clopidogrel but not to aspirin may contribute to smaller anti-inflammatory response in patients with ST-elevation myocardial infarction.

Cited by 13 publications

References 20 publications

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions

Effects of P2Y12 receptor antagonists beyond platelet inhibition – comparison of ticagrelor with thienopyridines

Clinical Utility of the PFA-100

Contact Info

Product

Resources

About

Effects of P2Y₁₂ receptor antagonists beyond platelet inhibition – comparison of ticagrelor with thienopyridines