ABSTRACT
High platelet reactivity (HPR) during dual-antiplatelet therapy is a marker of vascular risk, in particular stent thrombosis, in patients with acute coronary syndromes. Genetic determinants (CYP2C19*2 polymorphism), advanced age, female gender, diabetes and reduced ventricular function are related to a higher risk to develop HPR. In addition, inflammation and increased platelet turnover, as revealed by the elevated percentage of reticulate platelets in patients' blood, that characterize the acute phase of acute coronary syndrome are associated with HPR. To overcome the limitation of clopidogrel, new antiplatelet agents (prasugrel and ticagrelor) were developed and the demonstration of their superiority over clopidogrel was obtained in the two randomized trials, TRITON TIMI 38 and PLATO. Due to the current possibility not a choice between multiple antiplatelet strategies, the future prospect is to include, in addition to clinical data and classical risk factors, the definition of platelet function during treatment in order to set a tailored therapy.
Subject(s)
Acute Coronary Syndrome/drug therapy , Platelet Aggregation Inhibitors/therapeutic use , Acute Coronary Syndrome/blood , Adenosine/analogs & derivatives , Adenosine/pharmacokinetics , Adenosine/therapeutic use , Blood Platelets/physiology , Clopidol/pharmacokinetics , Clopidol/therapeutic use , Humans , Piperazines/pharmacokinetics , Piperazines/therapeutic use , Platelet Aggregation Inhibitors/pharmacokinetics , Prasugrel Hydrochloride , Thiophenes/pharmacokinetics , Thiophenes/therapeutic use , TicagrelorABSTRACT
A study was made of the distribution and depletion of clopidol residues at different tissue locations in chickens fed with feeds incurred with clopidol. Experiments showed that the residue levels were not identical at 5 different tissue locations in each chicken. The sequence of residue levels from high to low was livers, kidneys, upper breast, lower breast, and leg meat. The maximum residue values after suspension of the drug for 8 h were (mg/kg): livers, 4.600; kidneys, 3.619; upper breast, 1.742; lower breast, 1.641; leg meat, 1.525. The averages were taken after values for 10 chickens were determined. After suspension of the drug for 3 days, >80% residue clopidol was depleted, and the depletion was nearly completed within 7 days. The speed of depletion varied at different tissue locations in each chicken, with the sequence from fast to slow being equivalent to that of the residue levels. Analytical results of 350 samples during 7 days showed that the proposed method is specific for determination of clopidol in chickens.
