Please use this identifier to cite or link to this item: https://www.um.edu.mt/library/oar/handle/123456789/101944
Title: Clopidogrel has no effect on D-dimer and thrombin-antithrombin III levels in patients with peripheral arterial disease undergoing peripheral percutaneous transluminal angioplasty
Authors: Cassar, Kevin
Bachoo, Paul
Ford, Isobel
Greaves, Mike
Brittenden, Julie
Keywords: Blood coagulation disorders -- Diagnosis
Peripheral vascular diseases -- Treatment
Endovascular procedures -- adverse effects
Aspirin -- Therapeutic use
Issue Date: 2005
Publisher: Elsevier Inc.
Citation: Cassar, K., Bachoo, P., Ford, I., Greaves, M., & Brittenden, J. (2005). Clopidogrel has no effect on D-dimer and thrombin-antithrombin III levels in patients with peripheral arterial disease undergoing peripheral percutaneous transluminal angioplasty. Journal of vascular surgery, 42(2), 252-258.
Abstract: Objective: Coagulation activation markers are significantly elevated in patients with peripheral arterial disease compared with healthy controls. The more severe the disease, the higher the markers. Increased coagulation activation may contribute to the disease process and the risk of complications in patients with peripheral arterial disease, particularly after endovascular intervention. Animal studies have shown that clopidogrel significantly inhibits coagulation activation. The aim of this study was to determine whether combination of aspirin and clopidogrel affects thrombin-antithrombin III and D-dimer in patients with intermittent claudication undergoing angioplasty, compared with aspirin alone. Methods: This was a double blind, randomized placebo-controlled trial conducted in a vascular unit in a tertiary referral center. One hundred thirty-two patients with intermittent claudication were randomized to clopidogrel and aspirin or placebo and aspirin, with a loading dose 12 hours before endovascular intervention. D-dimer and thrombin-antithrom- bin III (TAT) levels were measured using enzyme-linked immunosorbent assay at baseline, 1 hour before, and 1 hour, 24 hours, and 30 days after intervention in 103 patients who underwent endovascular intervention. Results: There was a significant rise in D-dimer levels at 1 hour and 24 hours after angioplasty in both groups (placebo group: 63.69, 141.45, 122.18 ng/mL; clopidogrel group: 103.79, 159.95, 134.69 ng/mL), but no difference between the two groups (P .514). Similarly there was a significant rise in TAT levels at 1 hour after angioplasty in both groups (placebo group: 2.93, 6.16 g/L; clopidogrel group: 3.39, 5.27 g/L), with no significant difference between the two groups (P .746). Conclusion: Endovascular intervention results in a significant increase in TAT and D-dimer. The addition of clopidogrel to aspirin has no effect on TAT and D-dimer before or after endovascular intervention.
URI: https://www.um.edu.mt/library/oar/handle/123456789/101944
Appears in Collections:Scholarly Works - FacM&SSur



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