RT Journal Article
T1 Effects of intravenous lysine acetylsalicylate versus oral aspirin on platelet responsiveness in patients with ST‐segment elevation myocardial infarction: the ECCLIPSE‐STEMI trial
A1 Vivas Balcones, Luis David
A1 Jiménez, José Julio
A1 Martín Asenjo, Roberto
A1 Bernardo, Esther
A1 Ortega Pozzi, María Aranzazu
A1 Gómez Polo, Juan Carlos
A1 Moreno Muñoz, Guillermo
A1 Vilacosta, Isidre
A1 Pérez Villacastín, Julián
A1 Fernández Ortiz, Antonio Ignacio
AB Ensayo clínico aleatorizado multicéntrico que evaluó en 32 pacientes con infarto agudo de miocardio el efecto de la administración intravenosa de acetilsalicilato de lisina frente a aspirina oral. El estudio objetivó una inhibición plaquetaria más potente y precoz en los pacientes que recibieron acetilsalicilato de lisina intravenosa.Prasugrel and ticagrelor, new P2Y12-ADP receptor antagonists, are associated with greater pharmacodynamic inhibition and reduction of cardiovascular events in patients with an acute coronary syndrome. However, evidence is lacked about the effects of achieving faster and stronger cyclooxygenase inhibition with intravenous lysine acetylsalicylate (LA) compared to oral aspirin. Recently, we demonstrated in healthy volunteers that the administration of intravenous LA resulted in a significantly reduction of platelet reactivity compared to oral aspirin. Loading dose of LA achieves platelet inhibition faster, and with less variability than aspirin. However, there are no data of this issue in patients with an ST-segment elevation myocardial infarction (STEMI). This is a prospective, randomized, multicenter, open platelet function study conducted in STEMI patients. Subjects were randomly assigned to receive a loading dose (LD) of intravenous LA 450 mg plus oral ticagrelor 180 mg, or LD of aspirin 300 mg plus ticagrelor 180 mg orally. Platelet function was evaluated at baseline, 30 min, 1 h, 4 h and 24 h using multiple electrode aggregometry and vasodilator-stimulated phosphoprotein phosphorylation (VASP). The primary endpoint of the study is the inhibition of platelet aggregation (IPA) after arachidonic acid (AA) 0.5 mM at 30 min. Secondary endpoints were the IPA at 1, 4, and 24 h after AA, and non-AA pathways through the sequence (ADP and TRAP). A total of 32 STEMI patients were randomized (16 LA, 16 aspirin). The inhibition of platelet aggregation after AA 0.5 mM at 30 min was greater in subjects treated with LA compared with aspirin: 166 vs. 412 respectively (p = 0.001). This differential effect was observed at 1 h (p = 0.01), but not at 4 and 24 h. Subjects treated with LA presented less variability and faster inhibition of platelet aggregation wit AA compared with aspirin. The administration of intravenous LA resulted in a significantly reduction of platelet reactivity compared to oral aspirin on ticagrelor inhibited platelets in patients with STEMI. Loading dose of LA achieves an earlier platelet inhibition, and with less variability tan aspirin.
SN 0929-5305
YR 2023
FD 2023-02-01
LK https://hdl.handle.net/20.500.14352/99866
UL https://hdl.handle.net/20.500.14352/99866
LA eng
NO Vivas D, Jimenez JJ, Marttón-Asenjo R, Bernardo E, Ortega-Pozzi MA, Gómez-Polo JC, et al. Effects of intravenous lysine acetylsalicylate versus oral aspirin on platelet responsiveness in patients with ST-segment elevation myocardial infarction: the ECCLIPSE-STEMI trial. J Thromb Thrombolysis. 2023;55:203-210
NO Hospital San Carlos
NO Instituto de Salud Carlos III
DS Docta Complutense
RD 22 ago 2024