EFFECTS OF CARVEDILOL ON PLATELET AGGREGATION IN MEN WITH ST-ELEVATION ACUTE MYOCARDIAL INFARCTION
https://doi.org/10.20996/1819-6446-2010-6-2-149-159
Abstract
Aim. To study influence of beta-blockers carvedilol and metoprolol tartrate on platelet aggregative ability, evaluated by three different methods, in patients with acute ST segment elevation myocardial infarction (STEMI).
Material and methods. A total of 86 men aged 36-68 with uncomplicated STEMI were included into an open, comparative, randomized study. Patients were randomized into two groups of beta-blocker treatments. Patients (n=44) of the first group received carvedilol; patients (n=42) of the second one - metoprolol tartrate. Parameters of platelet hemostasis: the maximum amplitude and rate of platelet aggregation induced by ADP, ristomycin and collagen; mean platelet volume (MPV); serum level of soluble CD40 ligand (sCD40L) were evaluated on the 2nd and 24th day after STEMI onset.
Results. In patients with uncomplicated STEMI carvedilol more prominently reduced in vitro platelet aggregation induced by adenozin-5'-diphosphate in high concentration, ristomycin and collagen than metoprolol tartrate. Сarvedilol also more significantly decreased MPV in comparison with metoprolol tartrate. However, effect of both carvedilol and metoprolol tartrate on the level of another platelet aggregation marker - sCD40L was comparable.
Conclusion. Carvedilol and metoprolol tartrate have similar effect on platelet aggregation though in according to some tests carvedilol more prominently reduces platelet aggregation than metoprolol tartrate.
About the Authors
A. N. ZakirovaRussian Federation
Lenina ul. 3, Ufa, 450000
B. N. Garifullin
Russian Federation
Blukchera ul. 3, Ufa, 450009
F. S. Zarudij
Russian Federation
Lenina ul. 3, Ufa, 450000
N. E. Zakirova
Russian Federation
Lenina ul. 3, Ufa, 450000
References
1. Oganov RG, Pogosova GV. Contemporary strategies of prevention and treatment of cardiovascular diseases. Kardiologiia. 2007;47(12):4-9 (in Russian). / Оганов Р.Г., Погосова Г.В. Современные стратегии профилактики и лечения сердечно-сосудистых заболеваний. Кардиология 2007;47(12):4-9.
2. Kesteloot H, Sans S, Kromhout D. Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. Eur Heart J 2006;27(1):107-13.
3. Petrikova M, Jancinova V, Nosal R et al. Carvedilol - a beta-blocker with considerable antiaggregatory effect on human blood platelets. Bratisl Lek Listy 2005;106(1):20-5.
4. Preobrazhensky DV, Sidorenko BA, Dedova IS, Tarykina EV. β-Adrenoreceptor blockers in cardiovascular diseases treatment: the place of carvedilol. Kardiologiia. 2007;46(12):63-72 (in Russian). / Преображенский Д.В., Сидоренко Б.А., Дедова И.С., Тарыкина Е.В. Блокаторы β-адренорецепто- ров в лечении сердечно-сосудистых заболеваний: место карведилола. Кардиология 2006;46(12):63-72.
5. Myocardial infarction redefined - a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J 2000;21(18):1502-13.
6. Chen ZM, Pan HC, Chen YP, et al.; COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group. Early intravenous then oral metoprolol in 45 852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005;366(9497):1622-32.
7. Sackner-Bernstein JD. New evidence from the CAPRICORN trial: the role of carvedilol in high-risk, postmyocardial infarction patients. Rev Cardiovasc Med 2003;4(Suppl 3):S25-29.
8. Borja J, García O, Donado E, Izquierdo I. Clopidogrel and metoprolol in myocardial infarction. Lancet 2006;367(9513):811-2.
9. Gasser JA, Betterridge DJ. Comparison of the effects of carvedilol, propranolol, and verapamil on in vitro platelet function in healthy volunteers. J Cardiovasc Pharmacol 1991;18 Suppl 4:S29-34.
10. Novikov TA, Zarudiĭ FA, Zakirova AN. Nebivolol effects on platelet aggregation and anticoagulation system. Kardiologiia. 2003;43(7):70-6 (in Russian). / Новиков Т.А., Зарудий Ф.C., Закирова А.Н. Влияние небиволола на агрегацию тромбоцитов и противосвертывающую систему. Кардиология 2003;43(7):70-6.
11. Dash D, Rao K. Effect of propranolol on platelet signal transduction. Biochem J 1995;309(Pt 1):99- 104.
12. Butler S., Wang R., Wundler S. et al. Perturbing effects of carvedilol on a model membrane system: Role of lipophilicity and chemical structure. Biophys Chem 2006;119(3):307-15.
13. Cheng HY, Randall CS, Holl WW et al. Carvedilol-liposome interaction: evidence for strong association with hydrophobic region of lipid bilayers. Biochim Biophys Acta 1996;1284(1):20-8.
14. Khandekar MM, Khurana AS, Deshmukh SD et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol 2006;59(2):146-9.
15. Pizzulli L, Yang A, Martin JF, Lüderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J 1998;19(1):80-4.
16. Endler G, Klimesch A, Sunder-Plassmann H et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002;117(2):399- 404.
17. Brown AS, Hong Y, de Belder A et al. Megakaryocyte ploidy and platelet changes in human diabetes and atherosclerosis. Arterioscler Thromb Vasc Biol 1997;17(4):802-7.
18. Matsumura T, Tsushima K, Ohtaki E et al. Effects of carvedilol on plasma levels of interleukin-6 and tumor necrosis factor-alpha in nine patients with dilated cardiomyopathy.J Cardiol 2002;39(5):253- 7.
19. Nessler J, Nessler B, Kitliński M et al. Concentration of BNP, endothelin 1, pro-inflammatory cytokines (TNF-alpha, IL-6) and exercise capacity in patients with heart failure treated with carvedilol. Kardiol Pol 2008;66(2):144-51.
20. Kurum T, Tatli E, Yuksel M. Effects of carvedilol on plasma levels of pro-inflammatory cytokines in patients with ischemic and nonischemic dilated cardiomyopathy. Tex Heart Inst J 2007;34(1):52-9.
21. Shevchenko OP, Prirodova OF, Shevchenko AO, et al. CD40 ligand level - vascular inflammation activity and long-term prognosis in coronary heart disease patients. Kardiovaskulyarnaya Terapiya i Profilaktika 2008;7(1):39-45 (in Russian). / Шевченко О.П., Природова О.Ф., Шевченко О.А. и др. Уровень в крови лиганда sCD40L – активость сосудистого воспаления и отдаленный прогноз у больных ишемической болезнью сердца. Кардиваскулярная терапия профилактика 2008;7(1):39-45.
22. Heeschen C, Dimmeler S, Hamm CW. et al. Soluble CD40 ligand in acute coronary syndromes. N Engl J Med 2003;348(12):1104-11.
23. Varo N, de Lemos JA., Libby P et al. Soluble CD40L risk prediction after acute coronary syndromes. Circulation 2003;108(9):1049-52.
24. Aukrust P, Müller F, Ueland T et al. Enhanced levels of soluble and membrane-bound CD40 ligand in patients with unstable angina: possible reflection of T-lymphocyte and plateletinvolvementin the pathogenesis of acute coronary syndromes. Circulation 1999;100(6):614-20.
25. Marx N, Imhof A, Froehlich J et al. Effect of rosiglitazone treatment on soluble CD40L in patients with type 2 diabetes and coronary artery disease. Circulation 2003;107(15):1954-7.
Review
For citations:
Zakirova A.N., Garifullin B.N., Zarudij F.S., Zakirova N.E. EFFECTS OF CARVEDILOL ON PLATELET AGGREGATION IN MEN WITH ST-ELEVATION ACUTE MYOCARDIAL INFARCTION. Rational Pharmacotherapy in Cardiology. 2010;6(2):149-159. https://doi.org/10.20996/1819-6446-2010-6-2-149-159