No difference in the effects of clopidogrel and aspirin on inflammatory markers in patients with coronary heart disease

Svein Solheim; Alf Aage Pettersen; Harald Arnesen; Ingebjørg Seljeflot

doi:10.1160/TH06-06-0337

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(05): 660-664
DOI: 10.1160/TH06-06-0337

Endothelium and Vascular Development

Schattauer GmbH

No difference in the effects of clopidogrel and aspirin on inflammatory markers in patients with coronary heart disease

Svein Solheim

¹Clinical Cardiovascular Research Unit, Department of Cardiology, Ullevål University Hospital, Oslo, Norway

,

Alf Aage Pettersen

¹Clinical Cardiovascular Research Unit, Department of Cardiology, Ullevål University Hospital, Oslo, Norway

,

Harald Arnesen

¹Clinical Cardiovascular Research Unit, Department of Cardiology, Ullevål University Hospital, Oslo, Norway

,

Ingebjørg Seljeflot

¹Clinical Cardiovascular Research Unit, Department of Cardiology, Ullevål University Hospital, Oslo, Norway

› Author Affiliations

Abstract

Summary

Aspirin reduces several pro-inflammatory markers in patients with coronary heart disease (CHD), while limited data exists with clopidogrel. The aim of the present substudy of ASCET was to assess the influence of clopidogrel as compared to aspirin on selected circulating inflammatory markers in patients with stable angiographically verified CHD. Patients on treatment with aspirin 160 mg/day for at least seven days were randomized to either aspirin 160 mg/day (n=105) or clopidogrel 75 mg/day (n=101). Fasting blood samples were drawn at baseline and after one month and after one year for determination of high sensitivity C-reactive protein, tumor necrosis factor α (TNFα), interleukin 6, monocyte chemoattractant protein 1(MCP-1), CD40L, P-selectin, interleukin 10 and transforming growth factor. The groups were similar regarding demographic variables. There were no differences in any variables including changes from baseline to one month and one year between the groups. In the aspirin group we found significantly lower levels of TNFα and MCP-1 after one year; 1.00 versus 1.16 pg/ml (p<0.001) and 245 versus 261 pg/ml (p<0.001), respectively. Likewise, in the clopidogrel group the level of TNFα was significantly reduced after one year; 0.99 versus 1.19 pg/ml (p<0.001). In patients with CHD we found no between-group differences in circulating markers of inflammation after one year treatment with clopidogrel 75 mg/day compared to aspirin 160 mg/day, but in both groups lower levels of TNFα were obtained. The present results indicate similar anti-inflammatory effects of the two drugs.

Keywords

Antiplatelet agents - inflammation - atherosclerosis - randomized trial

Full Text

References

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