Universität zu Köln

Rudolph, Tanja K., Fuchs, Alexander, Klinke, Anna, Schlichting, Andrea, Friedrichs, Kai, Hellmich, Martin, Mollenhauer, Martin, Schwedhelm, Edzard, Baldus, Stephan and Rudolph, Volker (2017). Prasugrel as opposed to clopidogrel improves endothelial nitric oxide bioavailability and reduces platelet-leukocyte interaction in patients with unstable angina pectoris: A randomized controlled trial. Int. J. Cardiol., 248. S. 7 - 14. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754

Full text not available from this repository.

Abstract

Background: Platelet inhibition has been linked to improved endothelial function, a prognostic factor in coronary artery disease. Whether prasugrel, a potent platelet inhibitor, affects endothelial function remains unknown. Methods: This was a double-blind, randomized, active-controlled, parallel trial. Patients with unstable angina pectoris undergoing percutaneous coronary intervention (PCI) received either a daily dose of clopidogrel 75 mg (n = 23) or prasugrel 10 mg (n = 22). Flow-mediated dilation (FMD), circulating nitrate and nitrite, inflammatory markers and platelet-leukocyte aggregates (PLAs) were assessed the day after PCI and after 3 months. Results: Baseline patient demographics were well matched between treatment groups. Prasugrel led to a significant improvement of FMD after 3months (9.01 +/- 3.64% vs. 6.65 +/- 3.24%, p=0.001). In contrast, no significant change was observed in the clopidogrel group (7.21 +/- 2.84% vs. 6.30 +/- 2.97%, p=0.187). Adjusted for baseline FMD, hyperlipidemia and statin use, the treatment effect on change in FMD favoured prasugrel by an absolute 1.97% (95% CI 0.29% to 3.66%, p=0.023). A significant reduction of plasma hsCRP, myeloperoxidase and neutrophil elastase and an increase of nitrate levels were noted in both treatment arms. Interestingly, only prasugrel significantly reduced sCD40 ligand and RANTES and increased nitrite levels. Prasugrel reduced the ADP-stimulated increase in PLAs by 40% (IR: 82 to 13), whereas clopidogrel revealed no such effect (1% increase (IR: 13 to 50) (p=0.01). Conclusion: Prasugrel exhibits beneficial mid-term effects on endothelial nitric oxide bioavailability and inflammatory markers. (EudraCT number: 2009-015406-19). (C) 2017 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rudolph, Tanja K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Klinke, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlichting, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mollenhauer, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwedhelm, Edzard UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-210774
DOI:	10.1016/j.ijcard.2017.06.099
Journal or Publication Title:	Int. J. Cardiol.
Volume:	248
Page Range:	S. 7 - 14
Date:	2017
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1874-1754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-ARTERY-DISEASE; SOLUBLE CD40 LIGAND; FLOW-MEDIATED VASODILATION; NEUTROPHIL ACTIVATION; ANTIPLATELET THERAPY; CIRCULATING LEVELS; VASCULAR-DISEASE; PROGNOSTIC VALUE; DOUBLE-BLIND; DYSFUNCTION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21077