Related Experiment Videos

Effect of increased aspirin dose after stenting in association with ClOpidogrel: the FIASCO randomized study

Thomas Cuisset1, Corinne Frere, Jacques Quilici

  • 1Department of Cardiology, CHU Timone, Marseille, 13385 France. thomascuisset@voila.fr

Thrombosis Research
|November 8, 2008
PubMed

Insights

Higher doses of aspirin (160 mg) did not improve antiplatelet response in patients with Drug-Eluting Stents (DES) compared to standard doses (75 mg). This study suggests 75 mg aspirin is sufficient with clopidogrel for DES patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis

Background:

  • Antiplatelet therapy variability necessitates dose optimization.
  • The optimal chronic aspirin dose post-Drug-Eluting Stent (DES) implantation remains debated.

Purpose of the Study:

  • To evaluate the efficacy of a higher aspirin dose (160 mg) versus standard dose (75 mg) combined with clopidogrel in patients with DES.
  • To assess the impact on aspirin responsiveness and non-COX-specific platelet aggregation.

Main Methods:

  • Prospective, randomized study of 50 patients with stable angina receiving DES.
  • Loading doses: 250 mg aspirin and 600 mg clopidogrel.
  • Patients randomized to 75 mg or 160 mg aspirin with 150 mg clopidogrel.
  • Platelet function assessed via Arachidonic Acid-induced aggregation (AA-Ag) and ADP-induced aggregation (ADP-Ag).

Main Results:

  • No significant difference in aspirin response (AA-Ag) between the 75 mg and 160 mg aspirin groups (p = 0.75).
  • No significant difference in non-COX-specific platelet inhibition (ADP-Ag) between groups (p = 0.61).

Conclusions:

  • Higher-dose aspirin (160 mg) offers no added benefit over 75 mg for aspirin responsiveness or non-COX-specific platelet inhibition in DES patients.
  • Current data do not support using higher aspirin doses than 75 mg with clopidogrel in DES patients due to potential increased bleeding risk.
Abstract

Related Concept Videos

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Drug toxicity: Drug–Drug Interaction01:30

Drug toxicity: Drug–Drug Interaction

Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...