Key result
Clopidogrel reduces platelet aggregation in ~67% of endotoxemic horses and blunts heart rate increases.
Why the study?
The effects of clopidogrel on clinical and clinicopathologic variables in healthy horses with experimentally induced endotoxemia were not well characterized.
RCT (n=12)
Blinded
Randomized
Clopidogrel may blunt select endotoxemia signs in horses; leaves open consistent efficacy and need for clinical trials.
OBJECTIVE: To evaluate the effects of clopidogrel on clinical and clinicopathologic variables in healthy horses with experimentally induced endotoxemia. ANIMALS: 12 adult mares. Procedures-Horses were assigned with a randomization procedure to receive clopidogrel (4 mg/kg, once, then 2 mg/kg, q 24 h; n = 6) or a placebo (6) through a nasogastric tube. After 72 hours of treatment, horses received lipopolysaccharide (LPS; 30 ng/kg, IV). Heart rate, respiratory rate, rectal temperature, CBC variables, plasma fibrinogen concentration, serum tumor necrosis factor-α concentration, plasma von Willebrand factor concentration, and measures of platelet activation (including ADP- and collagen-induced platelet aggregation and closure times, thrombelastography variables, and results of flow cytometric detection of platelet membrane P-selectin, phosphatidylserine, and microparticles) were determined at various times before and after LPS administration by investigators unaware of the treatment groups. Statistical analyses were performed with repeated-measures ANOVA. RESULTS: 4 of 6 clopidogrel-treated horses had significant decreases in ADP-induced platelet aggregation before and after LPS administration. Heart rate increased significantly after LPS administration only for the placebo group. No significant differences were detected between groups for CBC variables, closure time, and plasma concentration of fibrinogen or serum concentration of tumor necrosis factor-α, and no clinically relevant differences were detected for other hemostatic variables. CONCLUSIONS AND CLINICAL RELEVANCE: In this study, administration of LPS did not induce platelet hyperreactivity in horses on the basis of measures of platelet adhesion, aggregation, degranulation, and procoagulant activity. Administration of clopidogrel was associated with variable platelet antiaggregatory activity and attenuated some clinical signs of endotoxemia.
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Watts et al. (2014) conducted an RCT in Experimentally induced endotoxemia (n=12). Clopidogrel vs. Placebo was evaluated on Clinical and clinicopathologic variables including platelet activation. Clopidogrel administration in horses with experimentally induced endotoxemia decreased ADP-induced platelet aggregation in 4 of 6 treated horses and attenuated LPS-induced heart rate increases.
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