Triflusal in Patients With Aspirin Hypersensitivity Treated With Coronary Stent Implantation

Ferré, Georgina Fuertes; Monreal, S. Laita; Nadal, María del Rosario Ortas; Insa, Esther Sánchez; Rubio-Lezcano, Juan Sánchez; Osuna, José Gabriel Galache

doi:10.1016/j.rec.2017.05.007

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…We found no adverse reactions to triflusal and no cases of definite stent thrombosis. In accordance with these results, Latib et al [13] reported no adverse reactions or definite stent thrombosis in the 8 patients treated with triflusal, nor did we in 20 patients from one of our centers [15]. To the best of our knowledge, this is the largest series describing the use of triflusal in patients with CAD (all presenting with ACS) and ASAH.…”

Section: Discussionsupporting

confidence: 86%

Triflusal in Patients with Acute Coronary Syndrome and Acetylsalicylic Acid Hypersensitivity

et al. 2021

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Background: Acetylsalicylic acid hypersensitivity (ASAH) limits therapeutic options in patients with acute coronary syndrome (ACS), who benefit from dual antiplatelet therapy (DAPT), especially when undergoing stent implantation. Our aim was to evaluate the safety and efficacy of triflusal in patients with ACS and ASAH. Methods and Results: Two-center retrospective study of patients diagnosed with ACS and ASAH from January 1, 2000, to May 1, 2020. Sixty-six patients were treated with triflusal. ASAH was confirmed with tests in 15 patients (22.7%). Forty-nine patients (74.2%) presented history of other drug allergies. Fifty-nine patients (89.4%) underwent stent implantation. DAPT was prescribed for ≥12 months in 54 patients. No adverse reactions to triflusal were reported. During a median follow-up of 5.12 years [IQR 2.7–9.9], rate of cardiovascular (CV) mortality was 6.1%, nonfatal myocardial infarction 12.1%, and ischemic stroke 4.5%. No cases of definite stent thrombosis occurred. Bleeding Academic Research Consortium grade ≥2 was observed in 3 patients during follow-up. Conclusion: In this series of patients presenting with ACS and ASA hypersensitivity, triflusal showed good tolerability and was associated with a low rate of CV and bleeding events.

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Section: Discussionsupporting

confidence: 86%

Triflusal in Patients with Acute Coronary Syndrome and Acetylsalicylic Acid Hypersensitivity

et al. 2021

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“…The same study showed that in patients with aspirin hypersensitivity treated with a coronary stent, triflusal use was associated with a low rate of adverse events in the long term. No cases of stent thrombosis or hypersensitivity reactions to triflusal were reported [ 63 ]. Another study was conducted to assess the tolerability of triflusal in patients with aspirin-exacerbated respiratory disease (AERD), and the results showed that triflusal was well tolerated in these patients [ 61 ].…”

Section: Reviewmentioning

confidence: 99%

Efficacy, Safety, and Role of Antiplatelet Drugs in the Management of Acute Coronary Syndrome: A Comprehensive Review of Literature

Abubakar¹,

Raza²,

Hassan³

et al. 2023

Cureus

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Acute coronary syndrome (ACS) is a complex condition characterized by myocardial ischemia or infarction which can lead to significant morbidity and death. Antiplatelet drugs play a crucial role in the management of ACS and have been shown to minimize the incidence of significant adverse cardiovascular events and recurrent myocardial infarction (MI). This comprehensive literature review is intended to summarize current information on the effectiveness, safety, and function of frequently used antiplatelet medications in treating ACS.Aspirin, clopidogrel, prasugrel, ticagrelor, abciximab, tirofiban, dipyridamole, cilostazol, and novel antiplatelets are included in the review. Aspirin's effectiveness as a first-line antiplatelet medication in ACS is well established. It has significantly lowered the risk of serious adverse cardiovascular events. Clopidogrel, prasugrel, and ticagrelor are P2Y12 receptor inhibitors found to lower the incidence of recurrent ischemia episodes in ACS patients.Using glycoprotein IIb/IIIa inhibitors such as abciximab, tirofiban, and eptifibatide is effective in managing ACS, especially in high-risk patients. Dipyridamole effectively reduces the risk of recurrent ischemic events in patients with ACS, particularly when used with aspirin. Cilostazol, a phosphodiesterase III inhibitor, has also been shown to reduce the risk of major adverse cardiovascular events (MACE) in patients with ACS.Antiplatelet drugs' safety in managing ACS has also been well established. Aspirin is generally well-tolerated with a low risk of adverse effects, although the risk of bleeding events, particularly gastrointestinal bleeding, cannot be eliminated. The P2Y12 receptor inhibitors have been associated with a small increase in the risk of bleeding events, particularly in patients with a high risk of bleeding. The glycoprotein IIb/IIIa inhibitors are associated with a higher risk of bleeding than other antiplatelet drugs, especially in high-risk patients.To summarize, antiplatelet drugs play a crucial role in the management of ACS, and the efficacy and safety of these drugs have been well-established in the literature. The choice of antiplatelet drugs will depend on the patient's risk factors, including age, comorbidities, and bleeding risk. The novel antiplatelets may offer new therapeutic options for managing ACS, and further studies are needed to determine their role in managing this complex condition.

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“…Triflusal inhibits irreversibly the COX-1 activity but to a lesser extent compared with ASA [21][22][23] . Due to these characteristics, triflusal exerts a comparable efficacy but with a safer profile compared to ASA 24,25 . Several clinical trials have designed to highlight triflusal as a promising alternative drug versus ASA [14][15][16]26 .…”

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confidence: 99%

The synergistic effect of EPA and DHA with cyclooxygenase-1 inhibitors on platelet aggregation

Argyropoulou,

Tsouka,

Pantazi

et al. 2023

JAPT

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Aim: Consumption of omega-3 fatty acids docosahexaenoic acid (DHA, 22:6ω-3) and eicosapentaenoic acid (EPA, 20:5ω-3) from a variety of foods and supplements could reduce cardiovascular events. The antiplatelet drugs aspirin (ASA) and triflusal, bind to platelet cyclooxygenase-1, thus preventing the biosynthesis of thromboxane A2 from arachidonic acid. ASA, triflusal, and their combinations with DHA or EPA were evaluated against in vitro platelet aggregation induced by the agonists AA, ADP, or TRAP-6. Materials-Methods: Platelet Rich Plasma (PRP), isolated from blood of healthy volunteers was pre-incubated with acetylsalicylic acid, triflusal, EPA, DHA, or the drug-omega-3 combinations at various concentrations for 10min at 37ºC, prior to activation by AA, TRAP-6, and ADP (0.3mM, 10μM and 6μM, respectively). Platelet aggregation was determined by Light Transmittance Aggregometry. Results: DHA significantly improves ASA and triflusal’s inhibitory effect towards AA-induced platelet aggregation, while EPA enhanced only the antiplatelet activity of ASA. Moreover, only the combination of ASA with EPA exhibited enhanced inhibitory effect against platelet aggregation induced by ADP. Furthermore, the inhibition of ASA and triflusal on TRAP-6-induced platelet aggregation was enhanced when ASA or triflusal were combined with EPA. Conclusions: Both DHA and EPA inhibit AA, ADP and TRAP-6-induced platelet aggregation in a dose dependent manner. The results of this study suggest a potentially beneficial use of EPA and DHA supplementation, in conjunction with the antiplatelet drugs ASA and triflusal.

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Triflusal in Patients With Aspirin Hypersensitivity Treated With Coronary Stent Implantation

Cited by 3 publications

References 5 publications

Triflusal in Patients with Acute Coronary Syndrome and Acetylsalicylic Acid Hypersensitivity

Triflusal in Patients with Acute Coronary Syndrome and Acetylsalicylic Acid Hypersensitivity

Efficacy, Safety, and Role of Antiplatelet Drugs in the Management of Acute Coronary Syndrome: A Comprehensive Review of Literature

The synergistic effect of EPA and DHA with cyclooxygenase-1 inhibitors on platelet aggregation

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