Ticlopidine plus aspirin significantly reduced synergistic platelet aggregation compared to ticlopidine or aspirin alone (14.8% vs 75.8% and 59.1%, respectively; p < 0.0001).
Does ticlopidine plus aspirin reduce platelet aggregation and ATP release compared to either drug alone in healthy volunteers?
The combination of ticlopidine and aspirin synergistically inhibits platelet aggregation and ATP release compared to either agent alone, providing a mechanistic rationale for dual antiplatelet therapy.
Tasa de eventos absoluta: 14.8% vs 75.8%
valor p: p=<0.0001
Aspirin and ticlopidine are used to prevent arterial thrombosis. In some clinical settings ticlopidine is administered with aspirin for improving antithrombotic effect. We administered aspirin (100 mg/day), ticlopidine (500 mg/day), or ticlopidine and aspirin for 7 days to healthy volunteers. Platelet aggregation and ATP release induced by sodium arachidonate, ADP, or a combination of both were measured. Sodium arachidonate (0.25 mmol/L), which produces no platelet aggregation, combined with adenosine diphosphate (1 mumol/L), which produced a reversible platelet aggregation of 20% after ticlopidine, resulted in a synergistic platelet aggregation response in normal (74.6 +/- 9.2%) and in ticlopidine platelet-rich plasma (59.1% +/- 14.9%, p < 0.0001). Synergism after sodium arachidonate (0.75 mmol/L) plus adenosine diphosphate (4 mumol/L) fell from 75.8% +/- 11.0% and 59.1% +/- 15.6% after ticlopidine or aspirin, respectively, to 14.8% +/- 18.0% (p < 0.0001) after ticlopidine plus aspirin. Aspirin and ticlopidine alone did not inhibit adenosine triphosphate release as thoroughly as did aspirin plus ticlopidine. Aspirin or ticlopidine does not adequately prevent platelet activity as ticlopidine plus aspirin do. Addition of aspirin to treatment with ticlopidine improves their antiplatelet activity and better results could be obtained in arterial thrombotic prevention strategies.
Altman et al. (1999) studied Healthy volunteers. Ticlopidine plus aspirin vs. Aspirin (100 mg/day) or ticlopidine (500 mg/day) alone was evaluated on Synergistic platelet aggregation after sodium arachidonate (0.75 mmol/L) plus adenosine diphosphate (4 mumol/L) (p=<0.0001). Ticlopidine plus aspirin significantly reduced synergistic platelet aggregation compared to ticlopidine or aspirin alone (14.8% vs 75.8% and 59.1%, respectively; p < 0.0001).