Diurnal variation in platelet inhibition by clopidogrel

Repository of Nicolaus Copernicus University

Show simple item record

dc.contributor.author Koziński, Marek
dc.contributor.author Bielis, Liliana
dc.contributor.author Wiśniewska-Szmyt, Joanna
dc.contributor.author Boinska, Joanna
dc.contributor.author Stolarek, Wioleta
dc.contributor.author Marciniak, Agata
dc.contributor.author Kubica, Aldona
dc.contributor.author Grąbczewska, Zofia
dc.contributor.author Navarese, Eliano Pio
dc.contributor.author Andreotti, Felicita
dc.contributor.author Siller-Matula, Jolanta Maria
dc.contributor.author Rość, Danuta
dc.contributor.author Kubica, Jacek
dc.date.accessioned 2012-12-19T16:23:56Z
dc.date.available 2012-12-19T16:23:56Z
dc.date.issued 2012-12-19
dc.identifier.uri http://repozytorium.umk.pl/handle/item/267
dc.description.abstract Morning increase in the occurrence of myocardial infarction, stroke and sudden cardiac death is a well-recognized phenomenon, which is in line with a morning enhancement of platelet aggregation. We investigated whether platelet inhibition during clopidogrel and aspirin therapy varies during the day. Fifty-nine consecutive patients (45 men and 14 women) with first ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (pPCI) on dual antiplatelet therapy were prospectively enrolled into the study. Blood samples were collected 4 days after start of clopidogrel treatment at 6.00 a.m., 10.00 a.m., 2.00 p.m. and 7.00 p.m. Arachidonic acid and adenosine diphosphate (ADP)-induced platelet aggregation were assessed by impedance aggregometry. Platelet inhibition by clopidogrel was lowest in the midmorning: median ADP-induced platelet aggregation was 55%, 17% and 27% higher at 10.00 a.m. compared to 6.00 a.m., 2.00 p.m. and 7.00 p.m., respectively ( p<0.002). Nonresponsiveness to clopidogrel defined according to the device manufacturer was 2.4-fold more frequent in the midmorning than in the early morning. We observed a more pronounced midmorning increase in ADP-induced platelet aggregation in diabetic patients when compared to non-diabetics. In contrast, no diurnal variation in the antiplatelet effect of aspirin was observed. In conclusion, in patients presenting with STEMI undergoing pPCI, platelet inhibition by clopidogrel is less strong in the midmorning hours. This periodicity in platelet aggregation in patients on dual antiplatelet therapy should be taken into consideration when assessing platelet function in clinical studies.
dc.language.iso eng
dc.rights info:eu-repo/semantics/openAccess
dc.subject Platelet aggregation
dc.subject diurnal variation
dc.subject dual antiplatelet therapy
dc.subject acute myocardial infarction
dc.title Diurnal variation in platelet inhibition by clopidogrel
dc.type info:eu-repo/semantics/article

Files in this item

This item appears in the following Collection(s)

Show simple item record

Search repository

Advanced Search


My Account