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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Thromb+Thrombolysis
2020 ; 50
(2
): 468-472
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Effects of colchicine on platelet aggregation in patients on dual antiplatelet
therapy with aspirin and clopidogrel
#MMPMID32335777
Cirillo P
; Taglialatela V
; Pellegrino G
; Morello A
; Conte S
; Di Serafino L
; Cimmino G
J Thromb Thrombolysis
2020[Aug]; 50
(2
): 468-472
PMID32335777
show ga
Platelets aggregation leading to thrombosis plays a pivotal role in the
pathophysiology of acute coronary syndrome (ACS) and of stent thrombosis.
Antiplatelet therapy with aspirin plus an ADP-receptor inhibitor (ticagrerol,
prasugrel or clopidogrel) is recommended to reduce the risk of other
platelet-mediated events. Clopidogrel is recommended in patients with Chronic
Coronary Syndromes (CCS) or in ACS patients at high bleeding risk. Unfortunately,
up to 30% of patients are non-responders to clopidogrel and show residual high
platelet reactivity (HPR). Colchicine (COLC) is a drug with cardiovascular
effects. We have demonstrated that COLC might exert protective cardiovascular
effects by interfering with cytoskeleton rearrangement, a phenomenon involved in
platelet aggregation. Here, we investigate in vitro the effects of colchicine on
platelet aggregation of patients on DAPT with clopidogrel. Platelets obtained
from 35 CCS patients on therapy with clopidogrel were pre-incubated with COLC
10 µM before being stimulated with ADP (20 µM), or TRAP (25 µM) at 0, 30, 60 and
90 min to measure max aggregation by LTA. Platelets not COLC-preincubated served
as controls. Seven patients were pre-selected as clopidogrel non-responders. COLC
significantly reduced TRAP-induced platelet aggregation in clopidogrel responders
and non-responders. Interestingly, COLC inhibited ADP-induced platelet
aggregation in clopidogrel non-responders in which ADP still caused activation
despite DAPT. We demonstrate that COLC inhibits platelet aggregation in
clopidogrel non-responders with HPR despite DAPT with this ADP
receptor-inhibitor. Further in vivo studies should be designed to evaluate the
opportunity to prescribe colchicine after ACS/CCS to overcome the clopidogrel
limitations in the DAPT therapy.