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Clopidogrel attenuates coated-platelet production in patients undergoing elective coronary catheterization

Nicholas B Norgard1, S Saya, C L Hann

  • 1School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, University at Buffalo, Buffalo, NY 14260-1200, USA. nicknorgard@mac.com

Journal of Cardiovascular Pharmacology
|November 27, 2008
PubMed

Insights

Clopidogrel significantly reduced coated-platelet formation in patients undergoing coronary angiography. This study shows a potential new antithrombotic mechanism for clopidogrel beyond standard platelet aggregation inhibition.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Pharmacology

Background:

  • Coated-platelets are highly thrombotic and linked to increased thrombotic risk.
  • P2Y12 inhibition has shown potential in reducing coated-platelet formation in vitro.
  • This study investigates the in vivo effects of clopidogrel on coated-platelets.

Purpose of the Study:

  • To evaluate the impact of clopidogrel administration on coated-platelet formation in patients.
  • To determine if clopidogrel reduces the levels of coated-platelets in a clinical setting.

Main Methods:

  • 27 patients undergoing elective coronary angiography were enrolled.
  • Blood samples were collected at baseline, 24 hours post-clopidogrel, and 6 hours post-angiography.
  • Coated-platelet levels were measured using convulxin and thrombin with or without adenosine diphosphate (ADP).

Main Results:

  • Clopidogrel administration resulted in a significant 7.2% absolute reduction in coated-platelet levels (17.8% relative reduction).
  • Coated-platelet production stimulated by convulxin, thrombin, and ADP was significantly lowered by clopidogrel.
  • The study provides the first evidence of in vivo P2Y12 antagonist effects on coated-platelet formation.

Conclusions:

  • In vivo administration of clopidogrel partially attenuates coated-platelet formation.
  • This effect may represent a novel antithrombotic mechanism of clopidogrel.
  • Further research is needed to determine the clinical significance of this finding.
Abstract

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