title: Effect of Oral Anti-platelet Regimens on Platelet Aggregation using Chronolog Light Transmittance Aggregometry in Coronary Heart Disease Patients: An Observational Study.
abstract: BACKGROUND
  Coronary heart disease is one of the most common cardiac health problem in India. Anti-platelet therapy is the cornerstone in the management of coronary heart disease. The current study was undertaken to compare the effect of different oral anti-platelet regimens on percentage inhibition of platelet aggregation in coronary heart disease patients using chronolog light transmittance aggregometry.
  
  
  METHODS
  Blood samples of 215 consecutive patients diagnosed of coronary heart disease (Male: Female ratio- 142: 73) with mean age of 55.2 ±10.3 years, who underwent platelet aggregation test were analysed. Patients were either on aspirin, clopidogrel, prasugrel, cilostazol or a combination of these drugs in different dosages. Of the 215 coronary heart disease patients, 35, 115 and 65 patients were on single, dual and triple anti-platelet drug regimen respectively.
  
  
  RESULTS
  The Percentage Inhibition of Platelet Aggregation (%IPA) in patients on dual anti-platelet regimen was highest i.e., 65.14 ± 23.23 as compared to 48.89 ± 22.16 in patients on monotherapy and 62.14 ± 21.64 in patients on triple anti-platelet regimen. Percentage of responders (> 40% inhibition of platelet aggregation) were 54.28%, 73.91% and 64.61% in single, dual and triple drug regimens respectively. Among responders on dual anti-platelet regimen, 64.7% were on aspirin + prasugrel and 35.3% were on aspirin + clopidogrel. The Percentage Inhibition of platelet aggregation in diabetics on dual anti-platelet regimen was 71.69 ± 17.54 as compared to 56.14 ± 23.29 in diabetics on triple anti-platelet regimen.
  
  
  CONCLUSIONS
  Dual anti-platelet therapy containing prasugrel was found to be more effective than dual anti-platelet therapy containing clopidogrel on background aspirin therapy and triple anti-platelet therapy in terms of percentage inhibition of platelet aggregation in coronary heart disease patients especially those with concomitant diabetes, however this conclusion needs to be further confirmed by large-scale randomized clinical trials.
authors.affiliation: DM Residents, Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences , Panjagutta, Hyderabad, India .
authors.forename: Kishan
authors.initials: K
authors.lastname: P V
authors.affiliation: DM Residents, Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences , Panjagutta, Hyderabad, India .
authors.forename: Uday
authors.initials: U
authors.lastname: Kumar C
authors.affiliation: Professor & HOD, Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences , Panjagutta, Hyderabad, India .
authors.forename: Shobha
authors.initials: S
authors.lastname: J C
authors.affiliation: Additional Professor, Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences , Panjagutta, Hyderabad, India .
authors.forename: Usharani
authors.initials: U
authors.lastname: P
authors.affiliation: Lab Analyst, Clinical Pharmacology & Medical Research Laboratory, Nizam's Institute of Medical Sciences , Panjagutta, Hyderabad, India .
authors.forename: Chandrasekhar
authors.initials: C
authors.lastname: E
keywords: Coronary Heart Disease (CHD); Dual anti-platelet regimen; Light Transmittance Aggregometry (LTA); Oral Anti-platelet therapy; Percentage Inhibition of Platelet Aggregation (% IPA); Triple anti-platelet regimen