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Effects of Additional Sarpogrelate HCL on Inhibition of Platelet Function in Patients Underwent Percutaneous Coronary Intervention
동아대학교 의과대학 순환기내과
조용락, 김무현, 어룡호, 백희경, 이주영, 오영희, 장홍철, 김보성, 박태호, 김영대
Background and Objectives: Sarpogrelate HCL (Anplag) is a 5-hydroxytryptamine subtype 2A (5-HT2A) receptor antagonist. A previous study reported that adjunctive anplag of 300 mg to aspirin and ticlopidine reduced the rate of in-stent restenosis compared to control group. We sought to assess effects of 300-mg anplag in addition to aspirin and clopidogrel on platelet inhibition in patients underwent drug-eluting stents insertion. Subjects and Methods: This is a randomized, cross-over designed, prospective study. Thirty eligible patients were enrolled and received dual or triple antiplatelet therapies for 2 weeks and then crossed and administered to opposite therapy for 2 weeks. Platelet function tests by multiple electrode aggregometry and light transmittance aggregometry were performed just before and 2 and 4 weeks after administration. Results: Baseline platelet function was measured at 24±2 hours after administration of loading doses of 300-mg aspirin and 300-mg clopidogrel. We calculated percentage of platelet inhibition (PPI) as a formula: (POST-BASE)/BASE. Preliminary data showed no significant difference in comparison of percentage of platelet inhibition in both groups (table). Final result will be presented. Conclusions: Preliminary data suggested an adjunctive sarpogrelate HCL of 300 mg to aspirin and clopidogrel did not show an additional benefits on laboratory platelet inhibition compared to conventional dual therapy.
Table1. Comparison of platelet inhibion in both treated groups.
PPI (%) Dual therapy (aspirin + clopidogrel) Triple therapy (adjunctive sarpogrelate HCL) p-value

ADPtest-AUC

46.2±83.1%

36.1±62.5%

0.429

ASPItest-AUC

50.9±106.6%

21.2±78.3%

0.171

COLtest-AUC

29.1±69.2%

29.4±62.8%

0.478

10-uM ADP (LTA)

80.9±175.9%

46.1±115.4%

0.118

0.5-mM AA (LTA)

46.3±93.9%

88.5±158.1%

0.172

2-uM collagen (LTA)

329.8±759.0%

173.8±209.4%

0.384

PPI (percentage of platelet inhibition)  = (POST-BASE)/BASE x 100%


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