Research Journal of Pharmacology and Pharmacodynamics

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Post Stent Implantation Effect of Antiplatelet


Affiliations
1 Department of Pharmacy, JJT University, Vidyanagari, Churu Jhunjhunu Road, Chudela, District-Jhunjhunu–333001, Rajasthan, India
     

   Subscribe/Renew Journal


Here we found a clustering of death and MI events in the initial 90-day period after clopidogrel cessation, compared with subsequent follow-up intervals. Findings were consistent among subgroups of patients who received shorter or longer durations of clopidogrel therapy, patients with or without diabetes, and ACS patients who underwent PCI. The rate of adverse events in the initial 90-day interval after stopping clopidogrel was higher than the rate of adverse events following hospital discharge while patients were still taking clopidogrel. These findings support the hypothesis of a rebound hyperthrombotic period after clopidogrel cessation. They also highlight the need for additional studies to confirm these findings and to gain a deeper understanding of the pathophysiology of this phenomenon as well as allowing identification of strategies to attenuate this effect.

Clopidogrel keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.

Clopidogrel is used to prevent blood clots after a recent heart attack or stroke, and in people with certain disorders of the heart or blood vessels. We observed a clustering of adverse events in the initial 90 days after stopping clopidogrel among both medically treated and PCI-treated patients with ACS, supporting the possibility of a clopidogrel rebound effect.


Keywords

PCI (Percutaneous Coronary Intervention), ACS (Acute Coronary Syndrome), Clopidogrel, MI (Myocardial Infraction)
Subscription Login to verify subscription
User
Notifications
Font Size


  • http://blog.adpharm.net/2009/09/plavix-living-proof/ Bal dit Sollier C, Mahe I, Berge N, et al, “Reduced Thrombus Cohesion in an ex vivo Human Model of Arterial Thrombosis Induced by Clopidogrel Treatment: Kinetics of the Effect and Influence of Single and Double Loading-Dose Regimens,” Thromb Res, 2003, 111(1-2):19-27.

  • J. M. Pereillo, M. Maftouh, A. Andrieu, M. F. Uzabiaga, O. Fedeli, P. Savi, M. Pascal, J. M. Herbert, J. P. Maffrand, C. Picard (2002). "Structure and stereochemistry of the active metabolite of clopidogrel". Drug Metab. Dispos. 30 (11): 1288- 1295. doi:10.1124/dmd.30.11.1288. PMID 12386137. http://dmd.aspetjournals.org/cgi/reprint/30/11/1288.pdf.

  • Savi, P; Zachayus JL, Delesque-Touchard N et al. (July 2006). "The active metabolite of Clopidogrel disrupts P2Y12 receptor oligomers and partitions them out of lipid rafts". Proceedings of the National Academy of Sciences of the USA 103 (29): 11069- 11074. doi:10.1073/pnas.0510446103. PMID 16835302. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pub med&pubmedid=16835302.

  • http://ventrilocontrolpanel.com/forum/viewtopic.php?f=2&t=68 520

  • http://packageinserts.bms.com/pi/pi_plavix.pdf. Bal dit Sollier C, Mahe I, Berge N, et al, “Reduced Thrombus Cohesion in an ex vivo Human Model of Arterial Thrombosis Induced by Clopidogrel Treatment: Kinetics of the Effect and Influence of Single and Double Loading-Dose Regimens,” Thromb Res, 2003, 111(1-2):19-27.

  • Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006. ISBN 0- 9757919-2-3

  • Chan FK, Ching JY, Hung LC, et al. (2005). "Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding". N. Engl. J. Med. 352 (3): 238-44. doi:10.1056/NEJMoa042087. PMID 15659723.

  • Ho PM, Maddox TM, Wang L, Fihn SD, Jesse RL, Peterson ED, Rumsfeld JS. (2009). "Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome.". JAMA. 301 (9): 937-44. PMID 19258584.

  • Mega, J. L. (2009). "Cytochrome P-450 Polymorphisms and Response to Clopidogrel". New Engl. J. Med. 360: 354-362. doi:10.1056/NEJMoa0809171. PMID 19106084.

  • Simon, T. (2009). "Genetic Determinants of Response to Clopidogrel and Cardiovascular Events". New Engl. J. Med. 360: 363-375. doi:10.1056/NEJMoa0808227. PMID 19106083.

  • Collet, J (2009). "Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study". Lancet 373: 309. doi:10.1016/S0140-6736(08)61845-0.

  • unitcost.fda.moph.go.th/cl/.../document_20080131124726-1.pdf http://plavix.legalview.info/wikipedia/Clopidogrel/

  • www.accessdata.fda.gov/drugsatfda_docs/.../020839s040ltr.pdf

  • http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=11271,

  • Small DS, Farid NA, Payne CD, et al, “Effects of the Proton Pump Inhibitor Lansoprazole on the Pharmacokinetics and Pharmacodynamics of Prasugrel and Clopidogrel,” J Clin Pharmacol, 2008, 48(4):475-84.

  • www.umm.edu/altmed/drugs/clopidogrel-030450.htm

  • http://74.125.153.132/search?q=cache:EMDV0XHAbg8J:www. merck.com/mmpe/lexicomp/clopidogrel.html

  • PGxNews.Org (June 2009). "FDA updates Plavix label with PGx data". PGxNews.Org. http://www.pgxnews.org/web/thenews/ 1-latest-news/47-fda-updates-plavix-label-with-pgx-data. Retrieved 2009-06-13.

  • Diener HC, Bogousslavsky J, Brass LM, et al. (2004). "Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebocontrolled trial". Lancet 364 (9431): 331-7. doi:10.1016/S0140- 6736(04)16721-4. PMID 15276392

  • http://www.medscape.com/druginfo/dosage?drugid=5190&drug name=Clopidogrel+Oral&monotype=default

  • "New products and markets fuel growth in 2005". IMS Health. http://www1.imshealth.com/web/content/0,3148,64576068_638 72702_70260998_77974518,00.html. Retrieved 2009-03-02.

  • "Top Ten Global Products - 2007" (PDF). IMS Health. 2008- 02-26. http://www.imshealth.com/deployedfiles/imshealth/Global/Cont ent/StaticFile/Top_Line_Data/Top10GlobalProducts.pdf. Retrieved 2009-03-02.

  • "Preliminary Injunction Against Apotex Upheld on Appeal — Press Release". http://www.earthtimes.org/articles/show/news _press_release,32577.shtml. Retrieved 2007-09-05.

  • "U.S. judge upholds Bristol, Sanofi patent on Plavix". http://www.reuters.com/article/businessNews/idUSN193160782 0070619?pageNumber=1. Retrieved 2007-09-05.

  • http://www.drugs.com/sfx/clopidogrel-side-effects.html

  • http://www.mdconsult.com/das/pdxmd/body/167780134- 2/0?type=med&eid=9-u1.0-_1_mt_5112401

  • http://www.medscape.com/druginfo/dosage?drugid=5190&drug name=Clopidogrel+Oral&monotype=default

  • “A Randomized, Blinded, Trial of Clopidogrel Versus Aspirin in Patients at Risk of Ischaemic Events (CAPRIE). CAPRIE Steering Committee,” Lancet, 1996, 348(9083):1329-39.

  • Adams HP, del Zoppo G, Alberts MJ, et al, “Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups,” Stroke, 2007, 38(5):1655-1711. Available at http://stroke.ahajournals.org/cgi/reprint/STROKEAHA.107.181 486

  • Anderson JL, Adams CD, Antman EM, et al, “ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction: Executive Summary. A Report of the American College of Cardiology/American Heart

  • Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients with Unstable Angina/Non ST-Elevation Myocardial Infarction) Developed in Collaboration With the American College of Emergency Physicians, The Society of Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons,” J Am Coll Cardiol, 2007, 50(7):1-157. Available at http://content.onlinejacc.org/cgi/reprint/50/7/e1

  • Antman EM, Anbe DT, Armstrong PW, et al. “ACC/AHA 2007 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction),” J Am Coll Cardiol, 2004, 44(3):671-719. Available at http://www.acc.org/qualityandscience/clinical/guidelines/ stemi/Guideline1/index.htm

  • Bal dit Sollier C, Mahe I, Berge N, et al, “Reduced Thrombus Cohesion in an ex vivo Human Model of Arterial Thrombosis Induced by Clopidogrel Treatment: Kinetics of the Effect and Influence of Single and Double Loading-Dose Regimens,” Thromb Res, 2003, 111(1-2):19-27.

  • Sabatine MS, Cannon CP, Gibson CM, et al, “Addition of Clopidogrel to Aspirin and Fibrinolytic Therapy for Myocardial Infarction With ST-Segment Elevation,” N Engl J Med, 2005, 352(12):1179-89.

  • Scirica BM, Sabatine MS, Morrow DA, et al. “The Role of Clopidogrel in Early and Sustained Arterial Patency After Fibrinolysis for ST-segment Elevation Myocardial Infarction. The ECG Clarity-TIMI 28 Study,” J Am Coll Cardiol, 2006, 48(1):37-42.

  • Ho PM, Maddox TM, Wang L, et al, “Risk of Adverse Outcomes Associated With Concomitant Use of Clopidogrel and Proton Pump Inhibitors Following Acute Coronary Syndrome,” JAMA, 2009, 301(9):937-44.

  • Pezalla E, Day D, and Pulliadath I, “Initial Assessment of Clinical Impact of a Drug Interaction Between Clopidogrel and Proton Pump Inhibitors,” J Am Coll Cardiol, 2008, 52(12):1038-9.

  • Gilard M, Arnaud B, Le Gal G, et al, “Influence of Omeprazol on the Antiplatelet Action of Clopidogrel Associated to Aspirin,” J Thromb Haemost, 2006, 4(11):2508-9.

  • Gilard M, Arnaud B, Cornily JC, et al, “Influence of Omeprazole on the Antiplatelet Action of Clopidogrel Associated With Aspirin: The Randomized, Double-Blind Ocla (Omeprazole Clopidogrel Aspirin) Study,” J Am Coll Cardiol, 2008, 51(3):256-60.

  • Siller-Matula JM, Spiel AO, Lang IM, et al, “Effects of Pantoprazole and Esomeprazole on Platelet Inhibition by Clopidogrel,” Am Heart J, 2009, 157(1):148.e1-5.

  • Small DS, Farid NA, Payne CD, et al, “Effects of the Proton Pump Inhibitor Lansoprazole on the Pharmacokinetics and Pharmacodynamics of Prasugrel and Clopidogrel,” J Clin Pharmacol, 2008, 48(4):475-84.

  • Stanek EJ, Aubert RE, Flockhart DA, et al, “A National Study of the Effect of Individual Proton Pump Inhibitors on Cardiovascular Outcomes in Patients Treated With Clopidogrel Following Coronary Stenting: The Clopidogrel Medco Outcomes Study,” Society for Cardiovascular Angiography and Interventions 2009 Scientific Sessions; May 6, 2009; Las Vegas, NV.

  • http://www.merck.com/mmpe/lexicomp/clopidogrel.html

  • http://www.liveinternet.ru/showjournal.php?journalid=2826971 &tagid=1384740

  • ACP J Club. 2007 May-Jun;146(3):67. J Am Coll Cardiol. 2006 Dec 19;48(12):2592-5.

  • http://jama.ama-assn.org/cgi/content/short/299/5/532 JAMA. 2008;299(5):532-539.

  • J Am Coll Cardiol, 2006; 48:2592-2595, doi:10.1016/j.jacc.2006.10.025 (Published online 1 November 2006).© 2006 by the American College of Cardiology Foundation

  • Kaiser C, Brunner-La Rocca HP, Buser PT, et al; BASKET Investigators. Incremental cost-effectiveness of drug-eluting stents compared with a third-generation bare-metal stent in a real-world setting: randomised Basel Stent Kosten Effektivitats Trial (BASKET). Lancet. 2005;366:921-929.


Abstract Views: 355

PDF Views: 0




  • Post Stent Implantation Effect of Antiplatelet

Abstract Views: 355  |  PDF Views: 0

Authors

Jatin Patel
Department of Pharmacy, JJT University, Vidyanagari, Churu Jhunjhunu Road, Chudela, District-Jhunjhunu–333001, Rajasthan, India

Abstract


Here we found a clustering of death and MI events in the initial 90-day period after clopidogrel cessation, compared with subsequent follow-up intervals. Findings were consistent among subgroups of patients who received shorter or longer durations of clopidogrel therapy, patients with or without diabetes, and ACS patients who underwent PCI. The rate of adverse events in the initial 90-day interval after stopping clopidogrel was higher than the rate of adverse events following hospital discharge while patients were still taking clopidogrel. These findings support the hypothesis of a rebound hyperthrombotic period after clopidogrel cessation. They also highlight the need for additional studies to confirm these findings and to gain a deeper understanding of the pathophysiology of this phenomenon as well as allowing identification of strategies to attenuate this effect.

Clopidogrel keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.

Clopidogrel is used to prevent blood clots after a recent heart attack or stroke, and in people with certain disorders of the heart or blood vessels. We observed a clustering of adverse events in the initial 90 days after stopping clopidogrel among both medically treated and PCI-treated patients with ACS, supporting the possibility of a clopidogrel rebound effect.


Keywords


PCI (Percutaneous Coronary Intervention), ACS (Acute Coronary Syndrome), Clopidogrel, MI (Myocardial Infraction)

References