Platelet response to aspirin and clopidogrel in patients with peripheral atherosclerosis. 2011

Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
Department of Internal Medicine, Viborg Hospital , Heibergs Allé 4, 8800 Viborg, Denmark. ehmadsen@gmail.com

Aspirin and clopidogrel are important drugs in the secondary prevention of ischemic events. A considerable individual variation in platelet response to these drugs has, however, been reported, and high residual platelet reactivity despite treatment may be an independent risk factor for ischemic events. Most studies have been undertaken in patients with coronary heart disease, but patients with peripheral artery disease (PAD) may exhibit greater residual platelet reactivity, possibly because of platelet activation by a larger area of diseased endothelium. It is yet unsettled which method that best measures platelet reactivity and an eventual lack of response to aspirin. Several instruments are promoted to measure platelet response and low-response to platelet inhibitors, but it is questionable if they measure this in comparable ways. We studied the comparability of three tests of platelet reactivity for the assessment of low-response to aspirin and clopidogrel in patients with PAD. In 263 patients, platelet function was assessed twice, 3 months apart, by the Platelet Function Analyzer-100 (PFA), light transmission aggregometry (LTA), and whole blood impedance aggregometry (IA). In a subgroup of 43 patients, we studied the effect of a single dose of 600 mg clopidogrel on platelet function. Low-response to aspirin assessed by analyses targeting cyclooxygenase-1 activity (LTA, IA) was rare (≤ 8.1%). With the PFA, we found 17% with low response at both visits, and 60% who were consistently responsive, whereas 23% were categorized differently at the two visits. Low response to clopidogrel, occurred in 0-23%, depending on the method and the criteria used. A low-response to aspirin, defined by lack of COX-1 inhibition, is a rare phenomenon whereas high residual platelet reactivity as determined by PFA may be a rather frequent finding but is not consistent over time in all patients. A low-response to clopidogrel depends very much on the method and definition used.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010974 Platelet Aggregation The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS. Aggregation, Platelet
D010975 Platelet Aggregation Inhibitors Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system. Antiaggregants, Platelet,Antiplatelet Agent,Antiplatelet Agents,Antiplatelet Drug,Blood Platelet Aggregation Inhibitor,Blood Platelet Antagonist,Blood Platelet Antiaggregant,PAR-1 Antagonists,Platelet Aggregation Inhibitor,Platelet Antagonist,Platelet Antagonists,Platelet Antiaggregant,Platelet Antiaggregants,Platelet Inhibitor,Protease-Activated Receptor-1 Antagonists,Antiplatelet Drugs,Blood Platelet Aggregation Inhibitors,Blood Platelet Antagonists,Blood Platelet Antiaggregants,Platelet Inhibitors,Agent, Antiplatelet,Aggregation Inhibitor, Platelet,Antagonist, Blood Platelet,Antagonist, Platelet,Antiaggregant, Blood Platelet,Antiaggregant, Platelet,Drug, Antiplatelet,Inhibitor, Platelet,Inhibitor, Platelet Aggregation,PAR 1 Antagonists,Platelet Antagonist, Blood,Platelet Antiaggregant, Blood,Protease Activated Receptor 1 Antagonists
D010979 Platelet Function Tests Laboratory examination used to monitor and evaluate platelet function in a patient's blood. Function Test, Platelet,Function Tests, Platelet,Platelet Function Test,Test, Platelet Function,Tests, Platelet Function
D001792 Blood Platelets Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. Platelets,Thrombocytes,Blood Platelet,Platelet,Platelet, Blood,Platelets, Blood,Thrombocyte
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077144 Clopidogrel A ticlopidine analog and platelet purinergic P2Y receptor antagonist that inhibits adenosine diphosphate-mediated PLATELET AGGREGATION. It is used to prevent THROMBOEMBOLISM in patients with ARTERIAL OCCLUSIVE DISEASES; MYOCARDIAL INFARCTION; STROKE; or ATRIAL FIBRILLATION. Clopidogrel Besilate,Clopidogrel Besylate,Clopidogrel Bisulfate,Clopidogrel Hydrochloride,Clopidogrel Napadisilate,Clopidogrel Sandoz,Clopidogrel, (+)(S)-isomer,Clopidogrel-Mepha,Iscover,PCR 4099,PCR-4099,Plavix,SC 25989C,SC 25990C,SR 25989,Clopidogrel Mepha
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

Related Publications

Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
January 2021, Cardiology research and practice,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
June 1992, Investigative radiology,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
August 2006, Platelets,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
April 2007, Circulation,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
June 2006, Thrombosis and haemostasis,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
January 1998, Platelets,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
January 2019, Cureus,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
January 2016, Current vascular pharmacology,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
December 2007, Archives des maladies du coeur et des vaisseaux,
Esben Hjorth Madsen, and Norbert Rudolf Gehr, and Nils Lauge Johannesen, and Erik Berg Schmidt, and Søren Risom Kristensen
January 2008, Cerebrovascular diseases (Basel, Switzerland),
Copied contents to your clipboard!