Document Detail


Pharmacodynamic effects of clopidogrel in pediatric cardiac patients: A comparative study of platelet aggregation response.
MedLine Citation:
PMID:  22309046     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Little data on pediatric percent platelet aggregation (%PA) exist in the literature, particularly in cardiac patients and in response to clopidogrel. The objectives were to estimate the %PA range expected in pediatric patients and to measure the clopidogrel effect on %PA in the PICOLO (Platelet Inhibition in Children on Clopidogrel) trial. To estimate a neonatal/infant %PA response range, %PA induced by 5 µM adenosine diphosphate (ADP) was assessed using light transmission aggregometry in 16 cord and 11 normal adult blood samples and prior to clopidogrel therapy in 49 neonatal and 49 infant/toddler cardiac patients enrolled in PICOLO. The %PA induced by 5 µM thrombin receptor-activating peptide (TRAP) was also assessed for 10 neonates and 21 infants/toddlers enrolled in PICOLO and compared with 11 adult samples. Percent inhibition of platelet aggregation (%IPA) induced by 5 µM ADP at steady-state clopidogrel levels was assessed in 33 neonates and 39 infants/toddlers. ADP-induced %PA was lowest in cord blood samples, intermediate in study neonates and infants/toddlers, and highest in adults. Similarly, TRAP-induced platelet aggregation was lower in neonates and infants/toddlers than adults. For all groups, %PA and %IPA were highly variable, with 11% of neonates and 13% of infants/toddlers showing <10% IPA. In conclusion, ADP- and TRAP-induced %PA is lower in pediatric cardiac patients than normal adults, but highly variable in both. The lower baseline %PA may explain why the pediatric clopidogrel dose providing 30-50% IPA (0.20 mg/kg/day) is lower than a simple weight-based extrapolation of the adult dose (75 mg/day) providing similar inhibition.
Authors:
Lisa K Jennings; Alan D Michelson; Mary V Jacoski; Aditya Tyagi; Svetozar Grgurevich; Jennifer S Li; For The Picolo Investigators
Related Documents :
2774636 - Eyelid opening in preterm neonates.
11776676 - Incidence of meconium aspiration syndrome in term meconium-stained babies managed at bi...
4029516 - What mothers know about their newborns' visual skills.
1920766 - Severe hypernatraemia in a very preterm infant.
1809606 - Maternal mortality and its prevention.
7143166 - Dietary protein-induced colitis in breast-fed infants.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-6
Journal Detail:
Title:  Platelets     Volume:  -     ISSN:  1369-1635     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208117     Medline TA:  Platelets     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Vascular Biology Center of Excellence, University of Tennessee Health Science Center , Memphis, TN , USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Rapid-onset heparin-induced thrombocytopenia without previous heparin exposure.
Next Document:  Measurement of platelet responsiveness using antibody-coated magnetic beads for lab-on-a-chip applic...