Antiplatelet therapy: present status and its future directions

Ahluwalia, Kaza; Bhanwra, Sangeeta

doi:10.5455/2319-2003.ijbcp20140402

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…The risk of such event was partly attributed to the fact that aspirin is unable to inhibit platelet function in some patients. This so-called "variability of response" is estimated to occur in as much as 5-60% of patients [15].…”

Section: Aspirinmentioning

confidence: 99%

“…It is an inactive pro-drug that requires hepatic cytochrome P450 (CYP) system oxidation to release its active metabolite, which binds irreversibly through covalent modification to the ADP-coupled P2Y12 receptor [15]. There is considerable inter-individual variability in response to clopidogrel, current data suggesting that about 10% to 50% of patients treated with conventional doses do not display adequate anti-platelet response [17][18][19][20].…”

Section: Clopidogrelmentioning

confidence: 99%

“…This particular enzyme produces the cyclic endoperoxide precursor of TxA2, thereby blocking the thromboxane-mediated pathway. Since platelets lack the synthetic machinery to produce significant amounts of new COX, the effect of aspirin is permanent, throughout the entire life of the platelet, and the inhibitory effect will become cumulative when aspirin is administered once every day [14,15]. Aspirin treatment reduces the number of thrombotic events in high risk patients by almost 25% [16].…”

Section: Aspirinmentioning

confidence: 99%

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Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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It is well known that critically ill patients require special attention and additional consideration during their treatment and management. The multiple systems and organ dysfunctions, typical of the critical patient, often results in different patterns of enteral absorption in these patients. Anti-platelet drugs are the cornerstone in treating patients with coronary and cerebrovascular disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment of choice in patients undergoing elective percutaneous coronary interventions and is still widely used in patients with acute coronary syndromes. However, despite the use of dual anti-platelet therapy, some patients continue to experience cardiovascular ischemic events. Recurrence of ischemic events is partly attributed to the fact that some patients have poor inhibition of platelet reactivity despite treatment. These patients are considered low-or nonresponders to therapy. The underlying mechanisms leading to resistance are not yet fully elucidated and are probably multifactorial, cellular, genetic and clinical factors being implicated. Several methods have been developed to asses platelet function and can be used to identify patients with persistent platelet reactivity, which have an increased risk of thrombosis. In this paper, the concept of anti-platelet therapy resistance, the underlying mechanisms and the methods used to identify patients with low responsiveness to anti-platelet therapy will be highlighted with a focus on aspirin and clopidogrel therapy and addressing especially critically ill patients.

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Section: Aspirinmentioning

confidence: 99%

Section: Clopidogrelmentioning

confidence: 99%

Section: Aspirinmentioning

confidence: 99%

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Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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“…According to a study of the literature, the frequency of aspirin resistance varies greatly (4 to 45%) across various groups. Diverse methodologies employed by various studies to determine aspirin resistance might be one cause for the increased discrepancy 1,2,16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…This makes it the best remedy in this category. The administration of antiplatelet dosages of acetyl salicylic acid on a daily basis has been found to reduce the risk of death from ischemic cardiovascular events by 40% 2 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Pharmacological Aspirin Resistance and their Association with Gender and age in patients with Cardiovascular Disease

Sadia¹,

Rasool²,

Zaman³

et al. 2021

PJMHS

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Background: Atherosclerosis is widely known to increase the risk of developing ischemic vascular events such as angina, transient ischemic attack, myocardial infarction and ischemic strokes. By using various methodologies aspirin resistance ranges from 0.8 to 70.1 %. Objective: The objective of current study was evaluation of pharmacological aspirin resistance and their association with gender and age in patients with cardiovascular disease Methodology: The study design was cross sectional, done at the Department of Pharmacology, Bacha Khan Medical College, Mardan for duration of one year from January 2021 to January 2022. Chrono-Log Aggregometer (''Chrono-log, Havertown, Pa., USA'') was used to study platelet aggregation utilizing Arachidonic acid of 0.5mM as an agonist. All the analysis of data was carried out by employing IBM SPSS version 24. Results: In the current research, a total of 350 patients were enrolled. There were 238 (68%) males and 112 (32%) females. Based on the status of aspirin resistance, 51 (14.57%) participants show aspirin resistance. In the current study, statistically no significant association of aspirin resistance was observed with both age and gender (p˃.05). Conclusion: According to our findings, aspirin resistance is a growing concern in individuals with cardiovascular disease which might lead to failure of treatment and substantial side effects. There might be a variety of probable reasons linked to numerous biochemical and demographic factors, such as age and sex. To investigate mechanistic causes and clinical consequences of this phenomenon, more research with a large sample size is needed. Key words: Pharmacological; Aspirin resistance; Cardiovascular disease

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Integral Tests of the Hemostasis System in Assessing the Efficiency of Acetylsalicylic Acid in Patients with Ischemic Heart Disease

Melnichnikova

Nazarova

Сироткина

et al. 2022

Biochem. Moscow Suppl. Ser. B

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Antiplatelet therapy: present status and its future directions

Cited by 5 publications

References 29 publications

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Evaluation of Pharmacological Aspirin Resistance and their Association with Gender and age in patients with Cardiovascular Disease

Integral Tests of the Hemostasis System in Assessing the Efficiency of Acetylsalicylic Acid in Patients with Ischemic Heart Disease

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