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Increased aspirin or added clopidogrel overcomes inadequate platelet inhibition

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – In patients with diabetes and coronary heart disease, an impaired antiplatelet response to low-dose aspirin can be overcome by increasing the aspirin dose or adding clopidogrel, according to a report in the August 15th issue of the American Journal of Cardiology.

Whether increasing the aspirin dose or adding clopidogrel is more effective in overcoming an impaired antiplatelet response in diabetic patients taking low-dose aspirin for coronary heart disease has not been studied, the authors explain.

Dr. Mehmet Akif Duzenli from Selcuk University, Konya, Turkey and colleagues compared the effects of aspirin 300 mg/day and combined therapy with aspirin 100 mg/day and clopidogrel 75 mg/day on platelet function in 60 such patients whose platelet function was inadequately inhibited by aspirin 100 mg/day.

Both strategies significantly decreased ADP- and collagen-induced platelet aggregation, the authors report: 18 of 30 patients treated with aspirin 300 mg/day and 25 of 30 treated with aspirin 100 mg/day and clopidogrel 75 mg/day had adequate platelet inhibition.

Combined therapy with clopidogrel and aspirin reduced ADP-induced platelet aggregation significantly more than did the 300 mg dose of aspirin, the researchers note.

“Increasing the aspirin dose to 300 mg/day or adding clopidogrel to aspirin can provide adequate platelet inhibition in a significant number of those patients with impaired responses to low-dose aspirin,” the investigators conclude.

Am J Cardiol 2008;102:396-400.