Abstract
Background: There is a high risk of reocclusion after successful lower limb angioplasty. Platelets play a central role in this process. The aim of this study was to investigate the antiplatelet effect of a combination of aspirin and clopidogrel compared with aspirin alone in patients with claudication undergoing endovascular revascularization.
Methods: This was a double-blind randomized placebo-controlled trial. Some 132 patients were randomized to clopidogrel and aspirin or placebo and aspirin, with a loading dose 12 h before endovascular intervention. Flow cytometric measurements of platelet fibrinogen binding and P-selectin expression were taken as measures of platelet function at baseline, 12 h after the loading dose, and 1 h, 24 h and 30 days after intervention.
Results: Within 12 h of the loading dose, platelet activation in the clopidogrel group had decreased (P-selectin by 27.3 per cent, P = 0.017; fibrinogen binding by 34.7 per cent, P = 0.024; stimulated fibrinogen binding by 49.2 per cent, P < 0.001). No change was observed in the placebo group. Platelet function in the clopidogrel group was significantly suppressed compared with baseline at 1 h, 24 h and 30 days after endovascular intervention (stimulated fibrinogen binding by 53.9, 51.7 and 57.2 per cent respectively; all P < 0.001).
Conclusion: A combination of clopidogrel and aspirin inhibited platelet function more than aspirin alone in patients with claudication before and after angioplasty.
Original language | English |
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Pages (from-to) | 159-165 |
Number of pages | 7 |
Journal | British Journal of Surgery |
Volume | 92 |
Issue number | 2 |
Early online date | 17 Dec 2004 |
DOIs | |
Publication status | Published - Feb 2005 |
Keywords
- PERIPHERAL ARTERIAL-DISEASE
- BALLOON ANGIOPLASTY
- MYOCARDIAL-INFARCTION
- PLATELET ACTIVATION
- ILIAC ARTERIES
- THERAPY
- ATHEROSCLEROSIS
- PREVENTION
- OCCLUSION