Introduction: Clopidogrel inhibits platelet P2Y12 ADP receptors, while ADP, as an inductor of aggregation, stimulates both P2Y12 and P2Y1 platelet receptors. Despite a clinical loading dose routine with clopidogrel, some patients still experience coronary stent thrombosis suggesting persistent platelet activation. The VerifyNow-P2Y12 is a rapid assay that test platelet activity over 3 min and uses of the combination of ADP and prostaglandin E1 (PGE1) to directly measure the effects of clopidogrel on the P2Y12 receptor. ADP is used to maximally activate the platelets by binding to the P2Y1 and P2Y12 platelet receptors, while PGE1 is used to suppress the ADP-induced P2Y1-mediated increase in intracellular calcium levels.
Objective: The VERIfy Thrombosis risk ASsessment (VERITAS) was a prospective study designed to measure platelet response to clopidogrel therapy in subjects with multiple risk factors or history of vascular disease using this novel point-of-care assay.
Methods: 166 participants were enrolled in 4 participating sites. Data from 147 participants were analyzed after exclusion of 19 patients due to protocol violations. Platelets were assessed twice at baseline (before clopidogrel) and at 24 h post-loading 450 mg (110 participants) or 7 days after chronic clopidogrel treatment (75 mg/day) (37 patients). All participants received aspirin 81-325 mg for at least 2 days before the study enrollment. Results from the VerifyNow-P2Y12 assay are reported in P2Y12 reaction units (PRU).
Results: Clopidogrel therapy resulted in a mean 64.0+/-25.3% PRU reduction. No participant reached PRU inhibition below 10% of baseline. Distribution of PRU values for the VerifyNow-P2Y12 assay shows a separation from baseline to post-clopidogrel assay values with some overlap due to high inter-individual variations in response.
Conclusions: VerifyNow-P2Y12 is a reliable, fast and sensitive device suitable for monitoring of platelet inhibition during clopidogrel therapy.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.thromres.2006.01.019 | DOI Listing |
Front Cardiovasc Med
January 2025
Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Objective: This meta-analysis aims to evaluate the safety and efficacy of indobufen in the treatment of cardiovascular diseases, cerebrovascular diseases, and thromboembolic disorders. The primary focus is on the incidence of major adverse cardiovascular events (MACE), thrombosis, bleeding events, and adverse reactions. The results are intended to provide a reference for the clinical application of indobufen and suggest directions for further large-scale, multi-center, prospective studies.
View Article and Find Full Text PDFBackground: Anterior circulation stroke (ACS) differs from posterior circulation stroke (PCS) in several aspects. We hypothesize that the risk of early neurologic deterioration (END) and its responses to clopidogrel plus aspirin versus aspirin alone may be different between stroke territories.
Methods And Results: This was a prespecified post hoc analysis of ATAMIS (Antiplatelet Therapy in Acute Mild to Moderate Ischemic Stroke) trial and included patients with definite infarct location who were classified into ACS and PCS according to stroke territory.
Br J Clin Pharmacol
January 2025
College of Pharmacy, Pusan National University, Busan, Republic of Korea.
Aims: We aimed to examine the recent trends in the use of acid suppression therapies, including proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs) and potassium-competitive acid blockers (P-CABs), in patients undergoing dual antiplatelet therapy (DAPT) as aspirin-clopidogrel following coronary stent implantation in South Korea between 2018 and 2022.
Methods: This observational study analysed data from the Health Insurance Review and Assessment Service (HIRA) on patients who underwent coronary stent implantation and received aspirin-clopidogrel DAPT. Patients who received acid suppression therapy for >60 days during DAPT were included in the analysis.
Front Pharmacol
January 2025
Department of Pharmacy, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Background: Stroke is the leading cause of disability globally, with antiplatelet therapy being crucial for secondary prevention but also increasing bleeding risks. This requires careful dosage adjustments to balance thrombosis and bleeding risks.
Objective: This study compared the efficacy and safety of low-dose versus standard-dose antiplatelet therapy in stroke patients.
Int Heart J
January 2025
Department of Cardiology, The First Affiliated Hospital of Dali University.
Ticagrelor, an effective antiplatelet for acute coronary syndrome (ACS), may elevate serum uric acid (SUA), potentially causing gout. This study aims to identify risk factors for ticagrelor-induced in-hospital gout in patients with ACS and create a predictive model for clinical use.A total of 1164 patients with ACS treated with ticagrelor (n = 640) or clopidogrel (n = 524) were retrospectively analyzed.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!