Antiaggregation effect of clopidogrel in coronary heart disease patients using omeprazole

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Dian Hasiannami Boru Munthe ◽  
Siti Sjamsiah Sargo ◽  
Mohammad Yogiarto
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Platelet Reactivity ◽  
Antiplatelet Agents ◽  
Cutoff Points ◽  
Gastrointestinal Side Effects ◽  
P2y12 Reaction Unit ◽  
Reaction Unit ◽  
Paired T Test

AbstractBackgroundAntiplatelet agents used in coronary heart disease (CHD) cause gastrointestinal side effects. Omeprazole can prevent and cure these antiplatelet side effects. Clopidogrel combined with aspirin increases the risk of gastrointestinal tract ulcers and bleeding. This research studied the effect of omeprazole on the antiplatelet effect of clopidogrel.MethodsCHD patients using clopidogrel and aspirin receive omeprazole 20 mg in a single dose for 10 days. Platelet antiaggregation point for clopidogrel was measured using VerifyNow P2Y12. The cutoff points used were: low on treatment platelet reactivity (LPR) <85 P2Y12 reaction unit (PRU), normal on treatment platelet reactivity (NPR) 85–208 PRU, and high on treatment platelet reactivity (HPR) >208 PRU.ResultsUsing the paired t-test PRU points pre- and post-omeprazole were 154 ± 85.89 PRU and 169.4 ± 56.15 PRU, respectively. The PRU points were consistent or decreased from the previous PRU points below the HPR cutoff (p: 0.215; >0.05). Before omeprazole use, five patients were categorized as NPR, two patients as LPR, and three patients as HPR. After omeprazole use, two patients, each from HPR and NPR category had a PRU point >208; the rest showed results below the HPR point.ConclusionsIn this study the PRU points of clopidogrel after omeprazole use showed a PRU <208. The hypothesis that omeprazole may reduce the antiaggregation effect of clopidogrel as shown by the increase in PRU above the cutoff points >208 PRU (HPR) was not proven.

scholarly journals Study of Utilization of Antiplatelet Agents in Coronary Heart Disease Patients in Private Hospital in Surabaya

2020 ◽  
Vol 7 (1) ◽  
pp. 99
Author(s):  
Ike Dhiah Rochmawati ◽  
Zakiah Rizka Rachmadania Arifin
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Private Hospital ◽  
Descriptive Analysis ◽  
Antiplatelet Agents ◽  
Observational Methods ◽  
Cross Sectional ◽  
Ischemic Events

ABSTRACT Antiplatelet is the most commonly drug used as secondary prevention for Coronary Heart Disease (CHD). The aim of this study was to determine the profile of the use of antiplatelet related with its efficacy and side effects. Observational methods with cross sectional approach for 3 months follow up was used,  a descriptive analysis carried out at the private hospital in Surabaya.  Results from this study: aspirin 80 mg was the most prescribed antiplatelet in patients with the incidence of ischemic events 9%. Higher ischemic events also seen in patients with hypertension, dyslipidemia, and Diabetes Mellitus. Bleeding and gastrointestinal disturbance as side effects occurred in 4 patients who used aspirin as antiplatelet, and based for Naranjo scale can be concluded as possible adverse drug reaction.  Keywords: Coronary Heart Disease, Antiplatelet , Ischemic events, Bleeding 

A 70-Year-Old Female with Unexpected Platelet Function Testing Results

2019 ◽  
Vol 51 (3) ◽  
pp. 310-314
Author(s):  
Moon Joo Kim ◽  
Pragna Patel ◽  
Niti Vyas ◽  
Christopher Leveque ◽  
Orlando Diaz ◽  
...  
Keyword(s):  
Active Metabolite ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
P2y12 Inhibitor ◽  
Light Transmission Aggregometry ◽  
P2y12 Reaction Unit ◽  
History Of ◽  
Reaction Unit ◽  
The Mean ◽  
Function Testing

Abstract A 70-year-old female with a history of hypertension and left A2 segment aneurysm was scheduled for pipeline embolization device (PED) placement. Preinterventional antiplatelet prophylaxis included aspirin and ticagrelor. Unexpectedly, after 13 days of treatment, VerifyNow showed a P2Y12 reaction unit (PRU) value of 216, approximately &gt;5 times the mean PRU of other patients on aspirin and ticagrelor. We confirmed platelet reactivity and ticagrelor resistance with light transmission aggregometry. Antiplatelet therapy was switched to prasugrel, and aspirin was continued. Eight days later, the P2Y12 reaction value (PRU) was 164. PED was placed without complications. Unlike clopidogrel, ticagrelor is a direct P2Y12 inhibitor that does not require metabolism to an active metabolite. Ticagrelor resistance is very rarely reported. To the best of our knowledge, there has been no case of ticagrelor resistance reported in the context of pre-PED placement prophylaxis.

scholarly journals SIDE EFFECTS PROFILE OF ANTIPLATELET MEDICATION IN PATIENTS WITH CORONARY HEART DISEASE AT BHAYANGKARA HOSPITAL BALI-INDONESIA

2020 ◽  
Vol 2 (2) ◽  
pp. 44
Author(s):  
Anak Agung Indah Astrijayanti ◽  
Made Krisna Adi Jaya ◽  
Ida Ayu Manik Partha Sutema ◽  
Ni Putu Wulanda Evayanti ◽  
Ni Ketut Tria Purnamisari
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Low Dose ◽  
Heart Function ◽  
User Group ◽  
Study Objective ◽  
Dose Aspirin ◽  
Antiplatelet Medication ◽  
Low Dose Aspirin

Introduction: Coronary heart disease (CHD) is a disorder of heart function due to a lack of blood in the heart muscle due to narrowing of the coronary arteries. Antiplatelet in patients with CHD is a therapy that must be obtained by patients throughout their lives to prevent recurrent attacks and deaths from CHD. In the Province of Bali, especially in Denpasar, there is a lack of information about the type of side effects that occur on antiplatelet medication, so it is necessary to do a related study. Objective: The aim of this study is to identify the type of side effects that occur on antiplatelet medication in patients with CHD. Methods: A cross-sectional study involving 97 patients was done by observed the CHD patients treated with antiplatelet medication. Side effects were evaluate using Naranjo Algorithm. Patients were divided into three groups, including a low dose aspirin user group, clopidogrel user group, and aspirin-clopidogrel combination user group. Results: Antiplatelet side effects that occur in patients include headache (2.06%), diarrhea (1.03%), cyanosis (1.03%), gastrointestinal bleeding (8.25%), heartburn (11.34%), and nausea (6.19%). These side effects only occurred in 31.96% of the total subjects. The incidence of aspirin side effects was significantly greater than clopidogrel as well as aspirin-clopidogrel in combination (p <0.05). Conclusion: Patients with CHD who use antiplatelet agents in the long term to be more aware of the potential side effects that will occur, especially heartburn in chronic low-dose aspirin users. Keywords: Coronary Heart Disease, Side Effects, Antiplatelet, Aspirin, Clopidogrel

scholarly journals Use of increased concentrations of adenosinediphosphate for high residual platelet reactivity in patients with coronary heart disease

2021 ◽  
Vol 70 (1) ◽  
pp. 129-132
Author(s):  
O.A. Trubacheva ◽  
S.N. Belyaeva ◽  
T.E. Suslova ◽  
I.V. Petrova
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Platelet Aggregation ◽  
Antiplatelet Therapy ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
Transmission Curve ◽  
Platelet Suspension

Detection of a tendency to increased thrombosis in patients with coronary heart disease (CHD) is of important prognostic value in the selection of drugs aimed at achieving a persistent antithrombotic effect. The aim of the study was to evaluate the use of elevated ADP inducer concentrations to improve the accuracy of ADP-induced platelet aggregation in patients with coronary heart disease. Material and method. Material and method. We studied 48 patients with CHD who were on continuous double antiplatelet therapy for 6 months (aspirin 75mg and clopidogrel 75mg per day). The aggregation activity of the platelet suspension was studied using the Born method G. in the modification of Gabbasov Z. A. Platelet activity was evaluated by the degree of aggregation of platelet-rich plasma along the light transmission curve under the influence of the inducer adenosine diphosphate (ADP) at a concentration of 2 mmol/l and by its own patented method against the background of additional ADP application. Results. In patients, platelet aggregation decreased to 5-35% (p<0.005) compared to the standard values, which are 50-60%. The values of platelet aggregation with the additional introduction of the inducer of aggregation ADP in a ratio of 2:1 to 2 µmol/l for 1, 2, 3, and 4-minute registration of platelet aggregation, resulted in increased aggregation from 55% to 75% (p<0.001), indicating high residual platelet reactivity on the background of double antiplatelet therapy. Correlations of the degree of aggregation for elevated ADP concentrations with multivessel arterial lesion and dyslipidemia were also found, r=0.86 and r=0.92, respectively. Conclusion. The use of elevated concentrations of adenosine diphosphate in platelet aggregation in patients with ischemic heart disease increases the accuracy of assessing ADP-induced platelet aggregation against the background of dual antiplatelet therapy and contributes to the detection of high residual platelet reactivity.

Are P2Y12 reaction unit (PRU) and % inhibition index equivalent for the expression of P2Y12 inhibition by the VerifyNow® assay? Role of haematocrit and haemoglobin levels

2011 ◽  
Vol 106 (08) ◽  
pp. 227-229 ◽  
Author(s):  
Sophie Voisin ◽  
Vanina Bongard ◽  
Mohammed A. Tidjane ◽  
Thibault Lhermusier ◽  
Didier Carrié ◽  
...  
Keyword(s):  
Platelet Reactivity ◽  
Clinical Events ◽  
Parallel Change ◽  
P2y12 Reaction Unit ◽  
Reaction Unit ◽  
Platelet Reaction ◽  
Leukocyte Counts ◽  
Definition Of ◽  
Inhibition Index

SummaryThe results of the whole blood VerifyNow® P2Y12 assay can be expressed as platelet reaction units (PRU) or % inhibition index (%inh), but an optimal cut-off for the assessment of high on-treatment platelet reactivity (HPR) predictive of clinical events has been validated only for PRU. The aim of the study was to study the influence of haematological variables, such as platelet and leukocyte counts or haematocrit / haemoglobin, within the limits indicated by the manufacturer for assay validity, on the results of the test. We performed a comparison of PRU and %inh in a series 186 samples obtained from a clinical trial on patients under dual antiplatelet therapy. The results show that PRU significantly decreases with increasing haematocrit / haemoglobin, whereas %inh does not, due to a parallel change in PRU and iso-TRAP baseline value. PRU and % inhibition index are not equivalent for the definition of HPR, because of their different sensitivities to haematocrit / haemoglobin.

scholarly journals Isolipan (dexfenfluramine) and its place in the treatment of obesity

1996 ◽  
Vol 42 (3) ◽  
pp. 38-40
Author(s):  
M. M. Ginzburg ◽  
G. S. Kozupitsa
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Developed Countries ◽  
Common Disease ◽  
Need For Treatment ◽  
Long Time ◽  
Treatment Of Obesity ◽  
Amphetamine Derivatives ◽  
Anorexigenic Effect

Obesity is the most common disease in the population of economically developed countries. 16-25% of the inhabitants of these countries have a body weight exceeding the norm by more than 15%. The increase in the incidence of obesity over the past 20 years is evident. The connection between obesity and such formidable diseases as hypertension, coronary heart disease, and type II diabetes is well known. At the same time, the current state of the problem of obesity therapy is far from perfect. Most patients, realizing the need for treatment, nevertheless cannot start it because of fear of the need to follow a half-starved diet for a long time. And although drugs that can reduce hunger, belonging to the group of amphetamine derivatives (ampheramone, fepranone, desopimon, etc.), have been known for more than 40 years, their use is limited due to frequent side effects (agitation, insomnia, palpitations, increased blood pressure, the development of drug dependence) and a large number of contraindications (hypertension, impaired carbohydrate tolerance, coronary heart disease, etc.). In this regard, the appearance of anorexigenic drugs of central serotonergic action, phenofluramine and later isolipan, IL (dexfenfluramine), which do not give such pronounced side effects and have relatively few contraindications, caused great interest. IL is a dextrorotatory isomer of fenfluramine and determines the anorexigenic effect of the latter.

scholarly journals The Role of Antiplatelet agents in ischemic events

2021 ◽  
Vol 11 (4-S) ◽  
pp. 187-194
Author(s):  
Sara Shreen ◽  
Mohammed Baleeqh Uddin ◽  
Mir Salman Ali ◽  
Zoha Sultana
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Blood Vessel ◽  
Pharmacological Treatment ◽  
Antiplatelet Agents ◽  
Antiplatelet Treatment ◽  
Coronary Diseases ◽  
Ischemic Events ◽  
Dual Antiplatelet Treatment

Antiplatelet treatment could be a key in pharmacological treatment for avoidance of coronary heart disease (CHD) and stroke. Depending on sign, term of antiplatelet monotherapy or double treatment is shifted. Antiplatelet treatment is shown to avoid a repeat of cardiovascular occasion, in any case, expanded term of dual antiplatelet treatment (DAPT) related with expanded hazard of bleeding. Unstable angina happens due to partially or totally block of the blood coronary blood vessel driving to coronary ischaemia. Intense coronary infection happens due to drawn out coronary ischaemia which causes coronary diseases. Keywords: dual antiplatelet treatment (DAPT), coronary heart disease (CHD) and stroke.

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