Abstract

Despite the substantial clinical success of aspirin and clopidogrel in secondary prevention of ischemic stroke, up to 40% of patients remain resistant to the available antiplatelet treatment. Therefore, there is an urgent clinical need to develop novel antiplatelet agents with a novel mechanism of action. Recent studies revealed that potent alpha 2B-adrenergic receptor (alpha 2B-ARs) antagonists could constitute alternative antiplatelet therapy. We have synthesized a series of N-arylpiperazine derivatives of 4,4-dimethylisoquinoline-1,3(2H,4H)-dione as potential alpha 2B receptor antagonists. The most potent compound 3, effectively inhibited the platelet-aggregation induced both by collagen and ADP/adrenaline with IC50 of 26.9 μM and 20.5 μM respectively. Our study confirmed that the alpha 2B-AR antagonists remain an interesting target for the development of novel antiplatelet agents with an alternative mechanism of action.

Highlights

  • Antiplatelet drugs are the mainstay of the pharmacological treatment for patients with various cardiovascular diseases1

  • Large clinical trials have revealed that treatment with antiplatelet agents such as clopidogrel and aspirin may reduce the risk of myocardial infraction, stroke or death by almost 22%2

  • Clopidogrel and aspirin act via a blockade of adenosine diphosphate (ADP) receptor and inhibition of cyclooxygenase-1 (COX-1)

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Summary

Introduction

Antiplatelet drugs are the mainstay of the pharmacological treatment for patients with various cardiovascular diseases. Large clinical trials have revealed that treatment with antiplatelet agents such as clopidogrel and aspirin may reduce the risk of myocardial infraction, stroke or death by almost 22%2. This fact has made them one of the most widely prescribed drugs in the world. Despite significant clinical success in preventing the adverse outcome of cardiovascular diseases, many patients experience recurrent atherothrombotic events, despite the treatment with antiplatelet agents. Many patients are resistant to aspirin and/or clopidogrel, which results in poor prognosis and increased risk of further cardiovascular events.

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