PMID- 16353041
OWN - NLM
STAT- MEDLINE
DCOM- 20060324
LR  - 20181203
IS  - 0022-9040 (Print)
IS  - 0022-9040 (Linking)
VI  - 45
IP  - 12
DP  - 2005
TI  - [Indirect comparison of changes of parameters of hemostasis during short-term use 
      of ticlopidine and clopidogrel in patients with non-ST elevation acute coronary 
      syndrome].
PG  - 11-6
AB  - Effects of thienopyridines ticlopidine (TIC) and clopidogrel (CL) on hemostasis 
      in patients (pts) with non-ST-elevation acute coronary syndromes (NSTEACS) have 
      not been compared. AIM: To compare changes of some markers of coagulation and 
      platelet activation during short term use of TIC and CL in pts with NSTEACS. 
      METHODS: Aspirin treated pts with NSTEACS (<48 hours from pain onset, Braunwald 
      class IIIb) were included into 2 consecutive studies: 37 pts receiving 
      unfractionated heparin (UFH) were randomized to open TIC (n=19, 500 mg BID for 2 
      days and 250 mg BID for subsequent 5 days) or no TIC (n=18); 19 pts receiving 
      enoxaparin were randomized to CL (n=10, 300 mg on day 1 and 75 mg/day for 
      subsequent 6 days) or no CL (n=9). At baseline, on days 1, 3, 7 and 14 (7 days 
      after thienopyridines discontinuation) we measured ADP-induced and spontaneous 
      platelet aggregation (PA), levels of prothrombin fragment 1+2 (F1+2), 
      thrombin-antithrombin complex (TAT), von Willebrand factor (vWF), fibrinogen, 
      tissue type plasminogen activator antigen (tPA), plasminogen activator inhibitor 
      activity (PAI) and D-dimer (Dd), and counted platelet number. RESULTS: Maximal 
      suppression of PA was obtained on 7-th and 3-rd days in TIC and CL groups, 
      respectively. Compared with their controls TIC treated pts in 7 days after TIC 
      discontinuation had lower levels of TAT (3.61 and 2.77 ng/ml, respectively, 
      r<0.05) and fibrinogen (3.84 and 3.16 g/l, respectively, r<0.05). There were no 
      significant differences between intervention and control groups in these 
      parameters in study with CL. Level of vWF in TIC treated pts was lower than in 
      controls on days 3 (163 and 186%, respectively, r<0.05) and 14 (144 and 173%, 
      respectively, p<0.01). In CL treated pts vWF level was lower relative to controls 
      on days 3 and 7 (152 and 185%, r<0.05, 141 and 166%, r<0.05, respectively). tPA 
      levels in study with TIC did not differ between intervention and control groups. 
      tPA in CL treated pts exceeded its level in controls on days 3, 7, and 14 (25.7 
      and 20.2 ng/ml, 26.5 and 12.9 ng/ml, 24.6 and 15.7 ng/ml, respectively). On the 
      same days level of Dd in pts receiving CL was significantly higher than in 
      control group (969 and 702 ng/ml, 970 and 575 ng/ml, 806 and 484 ng/ml on days 3, 
      7 and 14, respectively). Activity of PAI in TIC group was higher than in controls 
      on day 7 (13.6 and 8.2 U/l, r<0.05), and at this moment level of Dd was lower in 
      TIC treated patient (770 and 515 ng/ml in control and TIC groups, respectively, 
      r<0.05). CL and control groups had similar PAI activity. Mean platelet volume 
      rose relative to initial level and to control group only in CL treated patients 
      (9.0 and 8.4 fl, 9.6 and 8.4 fl, 9.4 and 8.5 fl in CL and control groups on days 
      0, 7 and 14, respectively; r<0.05 for comparison between groups on days 7 and 
      14). CONCLUSION: In pts with NSTEACS both thienopyridines attenuated acute phase 
      elevation of vWF. The use of TIC in UFH treated pts was associated with indirect 
      signs of decreased thrombin activity and some inhibition of fibrinolysis while 
      the use of CL in enoxaparin treated pts was associated with signs of activation 
      of fibrinolysis.
FAU - Slavina, N N
AU  - Slavina NN
FAU - Averkov, O V
AU  - Averkov OV
FAU - Gratsianskii, N A
AU  - Gratsianskii NA
LA  - rus
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Russia (Federation)
TA  - Kardiologiia
JT  - Kardiologiia
JID - 0376351
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 9005-49-6 (Heparin)
RN  - A74586SNO7 (Clopidogrel)
RN  - EC 3.4.21.5 (Thrombin)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Anticoagulants/pharmacology/therapeutic use
MH  - Aspirin/pharmacology/therapeutic use
MH  - Clopidogrel
MH  - Electrocardiography
MH  - Enoxaparin/pharmacology/therapeutic use
MH  - Fibrinolysis/drug effects
MH  - Fibrinolytic Agents/*administration & dosage/pharmacology
MH  - Hemostasis/*drug effects
MH  - Heparin/pharmacology/therapeutic use
MH  - Humans
MH  - Myocardial Infarction/blood/*drug therapy
MH  - Platelet Aggregation Inhibitors/*administration & dosage/pharmacology
MH  - Syndrome
MH  - Thrombin/analysis
MH  - Ticlopidine/*administration & dosage/*analogs & derivatives/pharmacology
MH  - Time Factors
EDAT- 2005/12/15 09:00
MHDA- 2006/03/25 09:00
CRDT- 2005/12/15 09:00
PHST- 2005/12/15 09:00 [pubmed]
PHST- 2006/03/25 09:00 [medline]
PHST- 2005/12/15 09:00 [entrez]
PST - ppublish
SO  - Kardiologiia. 2005;45(12):11-6.