Effect of long-term clopidogrel treatment on platelet function and inflammation in patients undergoing coronary arterial stenting.
A clopidogrel loading dose administered during stenting attenuates inflammation marker release. However, less is known of the anti-inflammatory effect of clopidogrel maintenance therapy. Platelet reactivity to adenosine diphosphate and inflammation markers were measured in 110 consecutive patients (69 clopidogrel-naive patients and 41 patients receiving long-term clopidogrel therapy for >6 months) before nonemergent stenting by turbidimetric aggregometry and flow cytometry and multianalyte profiling, respectively. All patients were treated with aspirin. Prestenting adenosine diphosphate-induced platelet aggregation, P-selectin, and activated glycoprotein IIb/IIIa expression were lower in patients receiving long-term clopidogrel therapy compared with the clopidogrel-naive group (p <0.001), accompanied by lower levels of selected inflammation markers (p < or = 0.05). Additionally, there were strong correlations between platelet aggregation and flow cytometric measurements (p < or = 0.04) and between specific inflammation markers (p < or = 0.02). In conclusion, in addition to markedly lowering platelet reactivity to adenosine diphosphate, long-term clopidogrel therapy is associated with an anti-inflammatory effect.
Antonino
Mark J
MJ
Sinai Center for Thrombosis Research, Baltimore, Maryland, USA.
Mahla
Elisabeth
E
Bliden
Kevin P
KP
Tantry
Udaya S
US
Gurbel
Paul A
PA
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001081:Apyrase / Q000494:pharmacology; D001792:Blood Platelets / Q000187:drug effects*; D000077144:Clopidogrel; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D019007:P-Selectin / Q000097:blood / Q000187:drug effects; D010865:Pilot Projects; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000032:analysis / Q000187:drug effects; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077144:Clopidogrel; D001081:Apyrase; D013988:Ticlopidine