Sarpogrelate Based Triple Antiplatelet Therapy Improved Left Ventricular Systolic Function in Acute Myocardial Infarction: Retrospective Study
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Purpose: The purpose of this study was to assess the potential benefit of a 5-hydroxytryptamine receptor antagonist, sarpogrelate-based triple antiplatelet therapy (TAPT) in comparison with dual antiplatelet therapy (DAPT) in patients undergoing primary percutaneouscoronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Materials and Methods: 119 patients of STEMI were retrospectively assessed. All patients received aspirin and clopidogrel per standard of care. Among them, 53 patients received an additional loading dose of sarpogrelate and a maintenance dose for 6 months post-PCI (TAPT group), while others did not (DAPT group). Results: The rates of complete ST-segment resolution at 30 minutes post-PCI and post-procedural thrombolysis in myocardial infarctionflow were not significantly different between the two groups (52.8% vs. 48.5%, p=0.200; 92.5% vs. 89.4%, p=0.080). In addition,no significant differences were observed between the two groups with regard to 30-day and 12-month clinical outcomes (cardiac death, myocardial infarction, stent thrombosis, target vessel revascularization, and severe bleeding). Meanwhile, improvementin left ventricular (LV) systolic function was observed in the TAPT group [ΔLV ejection fraction (LVEF)=17.1±9.4%, p<0.001; Δglobal longitudinal strain (GLS)=-9.4±4.2% , p<0.001] at 6 months, whereas it was not in the DAPT group (ΔLVEF= 8.8± 6.5%, p=0.090; ΔGLS=-4.6±3.4%, p=0.106). In multivariate analyses, TAPT was an independent predictor for LV functional recovery (odds ratio, 2.61; 95% confidence interval, 1.16–5.87; p=0.003). Conclusion: Sarpogrelate-based TAPT improved LV systolic function at 6 months in STEMI patients undergoing primary PCI.
Abstract
Purpose: The purpose of this study was to assess the potential benefit of a 5-hydroxytryptamine receptor antagonist, sarpogrelate-based triple antiplatelet therapy (TAPT) in comparison with dual antiplatelet therapy (DAPT) in patients undergoing primary percutaneouscoronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Materials and Methods: 119 patients of STEMI were retrospectively assessed. All patients received aspirin and clopidogrel per standard of care. Among them, 53 patients received an additional loading dose of sarpogrelate and a maintenance dose for 6 months post-PCI (TAPT group), while others did not (DAPT group). Results: The rates of complete ST-segment resolution at 30 minutes post-PCI and post-procedural thrombolysis in myocardial infarctionflow were not significantly different between the two groups (52.8% vs. 48.5%, p=0.200; 92.5% vs. 89.4%, p=0.080). In addition,no significant differences were observed between the two groups with regard to 30-day and 12-month clinical outcomes (cardiac death, myocardial infarction, stent thrombosis, target vessel revascularization, and severe bleeding). Meanwhile, improvementin left ventricular (LV) systolic function was observed in the TAPT group [ΔLV ejection fraction (LVEF)=17.1±9.4%, p<0.001; Δglobal longitudinal strain (GLS)=-9.4±4.2% , p<0.001] at 6 months, whereas it was not in the DAPT group (ΔLVEF= 8.8± 6.5%, p=0.090; ΔGLS=-4.6±3.4%, p=0.106). In multivariate analyses, TAPT was an independent predictor for LV functional recovery (odds ratio, 2.61; 95% confidence interval, 1.16–5.87; p=0.003). Conclusion: Sarpogrelate-based TAPT improved LV systolic function at 6 months in STEMI patients undergoing primary PCI.
참고문헌 (39)
- Angiolillo DJ, "The evolution of antiplatelet therapy in the treatment of acute coronary syndromes: from aspirin to the present day", Drugs, 72, pp.2087~2116 (2012)
- Franchi F, "Novel antiplatelet agents in acute coronary syndrome", Nat Rev Cardiol, 12, pp.30~47 (2015)
- Wallentin L, "Ticagrelor versus clopidogrel in patients with acute coronary syndromes", N Engl J Med, 361, pp.1045~1057 (2009)
- Wiviott SD, "Prasugrel versus clopidogrel in patients with acute coronary syndromes", N Engl J Med, 357, pp.2001~2015 (2007)
- Noh Y, "Antiplatelet therapy of cilostazol or sarpogrelate with aspirin and clopidogrel after percutaneous coronary intervention: a retrospective cohort study using the Korean National Health Insurance Claim Database", PLoS One, 11, pp.e0150475~ (2016)
- Chen KY, "Triple versus dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention", Circulation, 119, pp.3207~3214 (2009)
- Saini HK, "Therapeutic potentials of sarpogrelate in cardiovascular disease", Cardiovasc Drug Rev, 22, pp.27~54 (2004)
- Miyazaki M, "Sarpogrelate hydrochloride, a selective 5-HT2A antagonist, improves vascular function in patients with peripheral arterial disease", J Cardiovasc Pharmacol, 49, pp.221~227 (2007)
- Satomura K, "Sarpogrelate, a specific 5HT2-receptor antagonist, improves the coronary microcirculation in coronary artery disease", Clin Cardiol, 25, pp.28~32 (2002)
- Shikata C, "Effect of sarpogrelate on cardiovascular disorders", Exp Clin Cardiol, 16, pp.75~76 (2011)
- Schröder R, "Extent of early ST segment elevation resolution:a simple but strong predictor of outcome in patients with acute myocardial infarction", J Am Coll Cardiol, 24, pp.384~391 (1994)
- Reisner SA, "Global longitudinal strain: a novel index of left ventricular systolic function", J Am Soc Echocardiogr, 17, pp.630~633 (2004)
- GUSTO investigators, "An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction", N Engl J Med, 329, pp.673~682 (1993)
- Cutlip DE, "Clinical end points in coronary stent trials: a case for standardized definitions", Circulation, 115, pp.2344~2351 (2007)
- Stone GW, "Distal microcirculatory protection during percutaneous coronary intervention in acute ST-segment elevation myocardial infarction:a randomized controlled trial", JAMA, 293, pp.1063~1072 (2005)
- Grines CL, "Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians", Circulation, 115, pp.813~818 (2007)
- Snoep JD, "Association of laboratory-defined aspirin resistance with a higher risk of recurrent cardiovascular events: a systematic review and meta-analysis", Arch Intern Med, 167, pp.1593~1599 (2007)
- Snoep JD, "Clopidogrel nonresponsiveness in patients undergoing percutaneous coronary intervention with stenting: a systematic review and meta-analysis", Am Heart J, 154, pp.221~231 (2007)
- Lev EI, "Aspirin and clopidogrel drug response in patients undergoing percutaneous coronary intervention: the role of dual drug resistance", J Am Coll Cardiol, 47, pp.27~33 (2006)
- Müller I, "Effect of a high loading dose of clopidogrel on platelet function in patients undergoing coronary stent placement", Heart, 85, pp.92~93 (2001)
- Gawaz M, "Platelet function in acute myocardial infarction treated with direct angioplasty", Circulation, 93, pp.229~237 (1996)
- Storey RF, "Characterization of dyspnoea in PLATO study patients treated with ticagrelor or clopidogrel and its association with clinical outcomes", Eur Heart J, 32, pp.2945~2953 (2011)
- Scirica BM, "The incidence of bradyarrhythmias and clinical bradyarrhythmic events in patients with acute coronary syndromes treated with ticagrelor or clopidogrel in the PLATO (Platelet Inhibition and Patient Outcomes) trial: results of the continuous electrocardiographic assessment substudy", J Am Coll Cardiol, 57, pp.1908~1916 (2011)
- Roe MT, "Prasugrel versus clopidogrel for acute coronary syndromes without revascularization", N Engl J Med, 367, pp.1297~1309 (2012)
- Ashton JH, "Serotonin as a mediator of cyclic flow variations in stenosed canine coronary arteries", Circulation, 73, pp.572~578 (1986)
- Bush LR, "The effects of alpha 2-adrenergic and serotonergic receptor antagonists on cyclic blood flow alterations in stenosed canine coronary arteries", Circ Res, 55, pp.642~652 (1984)
- Eidt JF, "Thromboxane A2 and serotonin mediate coronary blood flow reductions in unsedated dogs", Am J Physiol, 257(3 Pt 2), pp.H873~H882 (1989)
- Faxon DP, "Acute effects of transluminal angioplasty in three experimental models of atherosclerosis", Arteriosclerosis, 2, pp.125~133 (1982)
- Steele PM, "Balloon angioplasty. Natural history of the pathophysiological response to injury in a pig model", Circ Res, 57, pp.105~112 (1985)
- Lam JY, "Deep arterial injury during experimental angioplasty: relation to a positive indium-111-labeled platelet scintigram, quantitative platelet deposition and mural thrombosis", J Am Coll Cardiol, 8, pp.1380~1386 (1986)
- Badimon L, "Platelet thrombus formation on collagen type I. A model of deep vessel injury. Influence of blood rheology, von Willebrand factor, and blood coagulation", Circulation, 78, pp.1431~1442 (1988)
- Pope CF, "Detection of platelet deposition at the site of peripheral balloon angioplasty using indium-111 platelet scintigraphy", Am J Cardiol, 55, pp.495~497 (1985)
- Heras M, "Effects of thrombin inhibition on the development of acute platelet-thrombus deposition during angioplasty in pigs. Heparin versus recombinant hirudin, a specific thrombin inhibitor", Circulation, 79, pp.657~665 (1989)
- Leosco D, "Intracoronary serotonin release after high-pressure coronary stenting", Am J Cardiol, 84, pp.1317~1322 (1999)
- Hara H, "MCI-9042, a new antiplatelet agent is a selective S2-serotonergic receptor antagonist", Thromb Haemost, 65, pp.415~420 (1991)
- Tanaka T, "Improvement of exercise capacity by sarpogrelate as a result of augmented collateral circulation in patients with effort angina", J Am Coll Cardiol, 32, pp.1982~1986 (1998)
- Grover GJ, "Protective effect of serotonin (5-HT2) receptor antagonists in ischemic rat hearts", J Cardiovasc Pharmacol, 22, pp.664~672 (1993)
- Shimizu Y, "The role of serotonin in ischemic cellular damage and the infarct size-reducing effect of sarpogrelate, a 5-hydroxytryptamine-2receptor blocker, in rabbit hearts", J Am Coll Cardiol, 40, pp.1347~1355 (2002)
- Horibe E, "Sarpogrelate, a 5-HT2 receptor blocker, may have a preconditioning-like effect in patients with coronary artery disease", Circ J, 68, pp.68~72 (2004)
