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Inhibition by combined therapy with ticlopidine and aspirin of enhanced platelet aggregation during physical exercise in patients with coronary artery disease.
Am Heart J 2001; 142(2):E1AH

Abstract

BACKGROUND

Strenuous exercise can be a major trigger for coronary thrombosis and it enhances platelet aggregation.

METHODS

We evaluated the effect of antiplatelet therapy on shear stress-induced platelet aggregation (SIPA), in addition to agonist-induced aggregation, before and immediately after ergometer exercise in patients with stable coronary artery diseases (CAD). Forty-eight patients with stable CAD were randomly distributed into 3 groups: no antiplatelet drug (patient control, n = 16), aspirin (ASA) monotherapy (n = 16), and combined therapy with ticlopidine (TIC) and ASA (n = 16).

RESULTS

There were significant increases in not only adenosine phosphate (ADP)- and collagen-induced platelet aggregation but also in SIPA during exercise by the patient control group. ASA monotherapy did not attenuate the enhanced ADP-induced aggregation nor SIPA. Combined ASA + TIC therapy significantly inhibited SIPA as well as ADP-induced aggregation both before and after exercise. Significant increases in levels of plasma von Willebrand factor (vWF) occurred during exercise, and these antiplatelet therapies had no apparent effect on increased vWF levels during exercise. Exercise induced a significant increase in the plasma thrombin-antithrombin III complex level with no significant changes in the level of plasmin-plasmin inhibitor complex level in all 3 groups.

CONCLUSIONS

Combined therapy with ASA + TIC effectively inhibited increased platelet aggregability in response to acute exercise, with no effects on coagulant or fibrinolytic potentials in patients with CAD. The data suggest that TIC combined with ASA may be superior to ASA alone in preventing acute coronary events during exercise in patients with coronary atherosclerotic disease.

Authors+Show Affiliations

1st and 2nd Departments of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11479480

Citation

Kitai, T, et al. "Inhibition By Combined Therapy With Ticlopidine and Aspirin of Enhanced Platelet Aggregation During Physical Exercise in Patients With Coronary Artery Disease." American Heart Journal, vol. 142, no. 2, 2001, pp. E1.
Kitai T, Nishikawa M, Tanigawa T, et al. Inhibition by combined therapy with ticlopidine and aspirin of enhanced platelet aggregation during physical exercise in patients with coronary artery disease. Am Heart J. 2001;142(2):E1.
Kitai, T., Nishikawa, M., Tanigawa, T., Okinaka, T., Wada, H., Shiku, H., ... Nakano, T. (2001). Inhibition by combined therapy with ticlopidine and aspirin of enhanced platelet aggregation during physical exercise in patients with coronary artery disease. American Heart Journal, 142(2), pp. E1.
Kitai T, et al. Inhibition By Combined Therapy With Ticlopidine and Aspirin of Enhanced Platelet Aggregation During Physical Exercise in Patients With Coronary Artery Disease. Am Heart J. 2001;142(2):E1. PubMed PMID: 11479480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inhibition by combined therapy with ticlopidine and aspirin of enhanced platelet aggregation during physical exercise in patients with coronary artery disease. AU - Kitai,T, AU - Nishikawa,M, AU - Tanigawa,T, AU - Okinaka,T, AU - Wada,H, AU - Shiku,H, AU - Ikeda,Y, AU - Ito,M, AU - Isaka,N, AU - Nakano,T, PY - 2001/8/2/pubmed PY - 2001/8/31/medline PY - 2001/8/2/entrez SP - E1 EP - E1 JF - American heart journal JO - Am. Heart J. VL - 142 IS - 2 N2 - BACKGROUND: Strenuous exercise can be a major trigger for coronary thrombosis and it enhances platelet aggregation. METHODS: We evaluated the effect of antiplatelet therapy on shear stress-induced platelet aggregation (SIPA), in addition to agonist-induced aggregation, before and immediately after ergometer exercise in patients with stable coronary artery diseases (CAD). Forty-eight patients with stable CAD were randomly distributed into 3 groups: no antiplatelet drug (patient control, n = 16), aspirin (ASA) monotherapy (n = 16), and combined therapy with ticlopidine (TIC) and ASA (n = 16). RESULTS: There were significant increases in not only adenosine phosphate (ADP)- and collagen-induced platelet aggregation but also in SIPA during exercise by the patient control group. ASA monotherapy did not attenuate the enhanced ADP-induced aggregation nor SIPA. Combined ASA + TIC therapy significantly inhibited SIPA as well as ADP-induced aggregation both before and after exercise. Significant increases in levels of plasma von Willebrand factor (vWF) occurred during exercise, and these antiplatelet therapies had no apparent effect on increased vWF levels during exercise. Exercise induced a significant increase in the plasma thrombin-antithrombin III complex level with no significant changes in the level of plasmin-plasmin inhibitor complex level in all 3 groups. CONCLUSIONS: Combined therapy with ASA + TIC effectively inhibited increased platelet aggregability in response to acute exercise, with no effects on coagulant or fibrinolytic potentials in patients with CAD. The data suggest that TIC combined with ASA may be superior to ASA alone in preventing acute coronary events during exercise in patients with coronary atherosclerotic disease. SN - 0002-8703 UR - https://www.unboundmedicine.com/medline/citation/11479480/Inhibition_by_combined_therapy_with_ticlopidine_and_aspirin_of_enhanced_platelet_aggregation_during_physical_exercise_in_patients_with_coronary_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(01)91534-0 DB - PRIME DP - Unbound Medicine ER -