title: Dual antiplatelet therapy in ACS: time-dependent variability in platelet aggregation during the first week.
abstract: OBJECTIVE
  Platelets play an important role in the pathogenesis of Acute Coronary Syndrome (ACS). Most of the complications of ACS occur during the initial hours of presentation. We tried to gain an insight into the platelet function during the initial phase of ACS in patients on dual antiplatelet therapy.
  
  
  METHODS
  Platelet aggregation study was performed by light transmittance aggregometry in 64 ACS patients 48 hour and 7 days after initiation of dual antiplatelet therapy with aspirin and clopidogrel.
  
  
  RESULTS
  Epinephrine, ADP and collagen induced platelet aggregation was significantly higher at 48 hours, following initiation of dual antiplatelet therapy, in comparison to the profile observed on the 7th day. Diabetics demonstrated a significantly higher aggregation at both the time points and aggregation was also somewhat higher in smokers though it did not reach statistical significance.
  
  
  CONCLUSIONS
  This study conceptualizes the hypothetical role of alpha-2 adrenoreceptor blockers during the early hours following ACS and also warrants further investigations exploring the optimum loading dose of antiplatelet agents, especially clopidogrel in patients with ACS.
authors.affiliation: Department of Cardiology, Medical College, Kolkata, India. guhas55@hotmail.com
authors.forename: Santanu
authors.initials: S
authors.lastname: Guha
authors.forename: Partha
authors.initials: P
authors.lastname: Sardar
authors.forename: Pradipta
authors.initials: P
authors.lastname: Guha
authors.forename: Suryyani
authors.initials: S
authors.lastname: Deb
authors.forename: Rathindranath
authors.initials: R
authors.lastname: Karmakar
authors.forename: Prantar
authors.initials: P
authors.lastname: Chakraborti
authors.forename: Soura
authors.initials: S
authors.lastname: Mookerjee
authors.forename: P K
authors.initials: PK
authors.lastname: Deb
authors.forename: Rajib
authors.initials: R
authors.lastname: De
authors.forename: Arnab
authors.initials: A
authors.lastname: Dutta
authors.forename: Utpal
authors.initials: U
authors.lastname: Chaudhuri
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011446:Prospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D014662:Vasoconstrictor Agents; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin; D004837:Epinephrine