Efficacy of different anti-platelet aggregation regimens before percutaneous transluminal angioplasty and stenting

Abstract

Objective To use thromboelastograph(TEG)technique for examining the platelet inhibition effect by aspirin and clopidogrel before percutaneous transluminal angioplasty and stenting(PTAS),so as to search for the optimal timing,dosage for clinical practice.Methods The clinical data of 93patients were divided into 4groups according to the aspirin history and different doses of aspirin before PTAS;the 4groups were:non-medication history with aspirin+lower dose aspirin(aspirin 100mg+clopidogrel 75mg,Group 1),non-medication history with aspirin+higher dose aspirin(aspirin 300mg+clopidogrel 75mg,Group 2),medication history with aspirin+lower dose aspirin(Group 3),and medication history with aspirin+higher dose aspirin(Group 4).The blood samples were collected on day 1,3after anti-platelet aggregation drugs;TEG technique was used to detect arachidonic acid(AA)-induced inhibition rate of platelet aggregation and adenosine diphosphate(ADP)receptor-induced inhibition rate of platelet aggregation.Results For different time points:in group 1,the inhibition rates of platelet aggregation of aspirin and clopidogrel were significantly higher on day 3(AA:[89.09±17.42]%,ADP:[57.02±23.97]%)as compared with those on day 1(AA:[82.24±22.25]%,ADP:[49.62±25.44]%;P0.05);in group 3,the inhibition rates of platelet aggregation were also significantly higher on day 3(AA:[95.06±8.05]%,ADP:[47.76±24.95]%)than those on day 1(AA:[88.88±14.66]%,ADP:[36.17±22.71)%]%;P0.05).For different doses:the AA-induced inhibition rates were not significantly different between group 1and group 2or between group 3and group 4on day 1and 3.Conclusion Without aspirin history,the inhibitory effect of platelet aggregation of aspirin before PTAS for 3dis better than that for 1d,and there is no difference between those of lower and higher doses.