Document Detail

Increased morning ADP-dependent platelet aggregation persists despite dual antiplatelet therapy in patients with first ST-segment elevation myocardial infarction: Preliminary report.
MedLine Citation:
PMID:  19039757     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Numerous trials have reported on the morning increase in the occurrence of myocardial infarction, stroke and sudden cardiac death. Similarly, enhanced morning platelet aggregation has been observed in healthy individuals and in subjects with coronary artery disease without adequate antiplatelet treatment. The purpose of the study was to assess circadian variation in platelet aggregation in patients with first ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (pPCI) and dual antiplatelet therapy.
METHODS: Fifteen consecutive patients (12 men and 3 women) were prospectively recruited into the study. Blood samples were collected at 6.00 a.m., 10.00 a.m., 2.00 p.m. and 7.00 p.m. on the third day of hospitalization. Aggregation in response to arachidonic acid and adenosine diphosphate (ADP) was assessed in the whole blood on a new generation impedance aggregometer.
RESULTS: A morning increase of 75% in ADP-dependent platelet aggregation was noted in the study population (p < 0.04). In contrast, we failed to show any significant diurnal variation in arachidonic acid-mediated platelet aggregation. The magnitude of the morning surge in platelet aggregation after ADP stimulation did not correlate with its baseline level.
CONCLUSIONS: Increased morning ADP-dependent platelet aggregation persists despite dual antiplatelet therapy in patients with first STEMI undergoing pPCI. The clinical significance of this finding remains to be demonstrated.
Marek Koziński; Liliana Bielis; Joanna Wiśniewska-Szmyt; Adam Sukiennik; Zofia Grabczewska; Iwona Swiatkiewicz; Michał Ziołkowski; Danuta Rość; Jacek Kubica
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  15     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2008  
Date Detail:
Created Date:  2008-11-28     Completed Date:  2009-04-07     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  530-6     Citation Subset:  IM    
Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
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MeSH Terms
Antibodies, Monoclonal / administration & dosage,  therapeutic use
Anticoagulants / administration & dosage,  therapeutic use
Circadian Rhythm / physiology*
Dose-Response Relationship, Drug
Drug Administration Routes
Drug Therapy, Combination
Follow-Up Studies
Heparin / administration & dosage,  therapeutic use
Immunoglobulin Fab Fragments / administration & dosage,  therapeutic use
Middle Aged
Myocardial Infarction / blood,  drug therapy*,  physiopathology
Platelet Aggregation / drug effects*
Platelet Aggregation Inhibitors / administration & dosage,  therapeutic use*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
Ticlopidine / administration & dosage,  analogs & derivatives,  therapeutic use
Treatment Outcome
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Anticoagulants; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 55142-85-3/Ticlopidine; 9005-49-6/Heparin; A74586SNO7/clopidogrel; X85G7936GV/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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