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IMPACT OF PENTOXIFYLLINE ON PLATELET FUNCTION PROFILES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH CORONARY ARTERY DISEASE ON DUAL ANTIPLATELET THERAPY
E1920 JACC April 5, 2011 Volume 57, Issue 14
i2 SUMMIT IMPACT OF PENTOXIFYLLINE ON PLATELET FUNCTION PROFILES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH CORONARY ARTERY DISEASE ON DUAL ANTIPLATELET THERAPY i2 Poster Contributions Ernest N. Morial Convention Center, Hall F Monday, April 04, 2011, 3:30 p.m.-4:45 p.m.
Session Title: Pharmacotherapy - Interventional Aspects Abstract Category: 21. Pharmacotherapy - Interventional Aspects Session-Poster Board Number: 2514-502 Authors: Masafumi Ueno, José L. Ferreiro, Salvatore D. Tomasello, Antonio Tello-Montoliu, Davide Capodanno, Naveen Seecheran, Kodlipet Dharmashankar, Murali Kodali, Andrew Darlington, Bhaloo Desai, Ronald K. Charlton, Theodore A. Bass, Dominick J. Angiolillo, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA, Jacksonville, FL Background: Phosphodiesterase (PDE) inhibitors, such as cilostazol and pentoxifylline, are associated with vasodilatory effects mediated by changes in cAMP levels in smooth muscle cells. Cilostazol is also associated with enhanced platelet inhibitory effects by increasing cAMP levels in patients on dual antiplatelet therapy (DAPT), a phenomenon which is marked in diabetes mellitus (DM) patients. Although pentoxifylline may reduce platelet reactivity in vitro, it’s ex vivo effects in DM patients treated with DAPT are unknown. Methods: This was a prospective, randomized, double-blind study conducted in 40 DM patients. All patients had stable coronary artery disease and were on DAPT with aspirin and clopidogrel. Patients were randomly assigned to either pentoxifylline 400mg or placebo three times daily for 14 days. Pharmacodynamic (PD) effects were assessed by vasodilator-stimulated phosphoprotein phosphorylation (VASP) assay, VerifyNow P2Y12 system, and light transmittance aggregometry (LTA) at baseline and 14 days. Results: Patients randomized to pentoxifylline (n=20) or placebo (n=20) were matched for clinical characteristics. At baseline, there were no differences in PD measures between patients randomized to pentoxifylline or placebo. At 14 days, there were no significant differences in PD measures between treatment groups (Table). Pharmacodynamic Effects of Pentoxifylline versus Placebo PRI (%) (mean ± SD) 20 μM ADP (%) (mean ± SD) 5 μM ADP (%) (mean ± SD) VerifyNow PRU (mean ± SD)
Pentoxifylline 62.0±16.8 55.4±10.1 45.7±11.9 269±97
Placebo 64.1±17.7 50.9±11.9 38.4±13.4 245±72
P value 0.55 0.22 0.07 0.37
Conclusion: Adjunctive treatment with pentoxifylline is not associated with increased platelet inhibitory effects in DM patients on DAPT.
i2 SUMMIT IMPACT OF PENTOXIFYLLINE ON PLATELET FUNCTION PROFILES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH CORONARY ARTERY DISEASE ON DUAL ANTIPLATELET THERAPY i2 Poster Contributions Ernest N. Morial Convention Center, Hall F Monday, April 04, 2011, 3:30 p.m.-4:45 p.m.
Session Title: Pharmacotherapy - Interventional Aspects Abstract Category: 21. Pharmacotherapy - Interventional Aspects Session-Poster Board Number: 2514-502 Authors: Masafumi Ueno, José L. Ferreiro, Salvatore D. Tomasello, Antonio Tello-Montoliu, Davide Capodanno, Naveen Seecheran, Kodlipet Dharmashankar, Murali Kodali, Andrew Darlington, Bhaloo Desai, Ronald K. Charlton, Theodore A. Bass, Dominick J. Angiolillo, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA, Jacksonville, FL Background: Phosphodiesterase (PDE) inhibitors, such as cilostazol and pentoxifylline, are associated with vasodilatory effects mediated by changes in cAMP levels in smooth muscle cells. Cilostazol is also associated with enhanced platelet inhibitory effects by increasing cAMP levels in patients on dual antiplatelet therapy (DAPT), a phenomenon which is marked in diabetes mellitus (DM) patients. Although pentoxifylline may reduce platelet reactivity in vitro, it’s ex vivo effects in DM patients treated with DAPT are unknown. Methods: This was a prospective, randomized, double-blind study conducted in 40 DM patients. All patients had stable coronary artery disease and were on DAPT with aspirin and clopidogrel. Patients were randomly assigned to either pentoxifylline 400mg or placebo three times daily for 14 days. Pharmacodynamic (PD) effects were assessed by vasodilator-stimulated phosphoprotein phosphorylation (VASP) assay, VerifyNow P2Y12 system, and light transmittance aggregometry (LTA) at baseline and 14 days. Results: Patients randomized to pentoxifylline (n=20) or placebo (n=20) were matched for clinical characteristics. At baseline, there were no differences in PD measures between patients randomized to pentoxifylline or placebo. At 14 days, there were no significant differences in PD measures between treatment groups (Table). Pharmacodynamic Effects of Pentoxifylline versus Placebo PRI (%) (mean ± SD) 20 μM ADP (%) (mean ± SD) 5 μM ADP (%) (mean ± SD) VerifyNow PRU (mean ± SD)
Pentoxifylline 62.0±16.8 55.4±10.1 45.7±11.9 269±97
Placebo 64.1±17.7 50.9±11.9 38.4±13.4 245±72
P value 0.55 0.22 0.07 0.37
Conclusion: Adjunctive treatment with pentoxifylline is not associated with increased platelet inhibitory effects in DM patients on DAPT.