期刊
PLATELETS
卷 30, 期 2, 页码 148-157出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/09537104.2019.1572880
关键词
Aspirin; bleeding; P2Y(12) inhibitors; thromboxane; ticagrelor
资金
- University of Sheffield
- British Heart Foundation [FS/15/82/31824]
Higher aspirin doses may be inferior in ticagrelor-treated acute coronary syndrome (ACS) patients and reducing bleeding risk whilst maintaining antithrombotic benefits could improve outcomes. We characterized the pharmacodynamics of a novel dual-antiplatelet-therapy regimen consisting of very-low-dose twice-daily (BD) aspirin with standard-dose ticagrelor. A total of 20 ticagrelor-treated ACS patients entered a randomized crossover to take aspirin 20 mg BD (12-hourly) during one 14-day period and 75 mg once-daily (OD) in the other. After 14 days of treatment, serum thromboxane (TX)B-2 and light-transmittance aggregometry were assessed pre- and 2 h post-morning-dose, bleeding time was measured post-dose, and TXA(2) and prostacyclin stable metabolites were measured in urine collected 2 h post-morning-dose. Data are expressed as mean +/- SD. After 14 days treatment, serum TXB2 levels were significantly greater 2 h post-dosing with aspirin 20 mg BD vs. 75 mg OD (3.0 +/- 3.6 ng/mL vs. 0.8 +/- 1.9 ng/mL; p = 0.018) whereas pre-dosing levels were not significantly different (3.5 +/- 4.1 ng/mL vs. 2.5 +/- 3.1 ng/mL, p = 0.23). 1-mmol/L arachidonic acid-induced platelet aggregation was similarly inhibited by both regimens pre-dose (8.5 +/- 14.3% vs. 5.1 +/- 3.6%, p = 0.24) and post-dose (8.7 +/- 14.2% vs. 6.6 +/- 5.3%; p = 0.41). Post-dose bleeding time was shorter with 20 mg BD (680 +/- 306 s vs. 834 +/- 386 s, p = 0.02). Urinary prostacyclin and TX metabolite excretion were not significantly different. In conclusion, compared to aspirin 75 mg OD, aspirin 20 mg BD provided consistent inhibition of platelet TXA(2) release and aggregation, and improved post-dose hemostasis, in ticagrelor-treated ACS patients. Further studies are warranted to assess whether this regimen improves the balance of clinical efficacy and safety.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据