Abstract 16074: Triple Antiplatelet Therapy (Aspirin, Clopidogrel, Cilostazol) Loading Followed by Maintenance Reduces Greater Serum Level of Scd40l and Tnf-a Than Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction Undergoing Pci: Two-Center, Prospective, Open Label, Randomized, Pilot Study
INTRODUCTION: The extensive crosstalk between platelet and inflammatory cells occurs during acute phase of AMI and antiplatelet agent has also anti-inflammatory effect
Hypothesis: Triple antiplatelet therapy (TAPT) may lower better systemic inflammation and platelet activity than dual antiplatelet therapy (DAPT) during acute phase of AMI
METHODS: Total 61 AMI patients undergoing PCI with DES were randomized into DAPT gr. (n=29) and TAPT gr. (n=31). DAPT gr. received aspirin 250mg+clopidogrel 600mg as a loading dose followed by aspirin 100mg/d + clopidogrel 75mg/d as a maintenance dose. TAPT gr. received aspirin 250mg + clopidogrel 600mg+cilostazol 400mg as a loading dose followed by aspirin 100mg/d + clopidogrel 75mg/d + cilostazol 200mg/d as a maintenance dose. All patients were statin-naïve and glycoprotein iib/iiia inhibitor was not used during PCI. We compared the level of biomarkers for systemic inflammation and platelet activation (IL-6, CRP, sCD40L, TNF-a, p-selectin) at admission, 1 day, 5 days and 30 days after PCI and also compared % reduction of biomarkers between two groups
Results: The platelet reactivity did not differ between two groups (fig 1). The median value at each sampling time and % reduction of CK-MB, Trop-T, hs-CRP, IL-6 and p-selectin did not differ between two groups (fig 1, fig 2). However, in cases of sCD40L and TNF-a, while the median value were similar between two groups at each sampling time, the level of % reduction were significantly greater in TAPT gr. than DAPT gr. (fig 2)
CONCLUSION: In conclusion, compared with DAPT, TAPT resulted in greater reduction in the serum level of sCD40L and TNF-α during acute phase of AMI
- © 2013 by American Heart Association, Inc.