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document
Impact of pentoxifylline on platelet function profiles in patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy with aspirin and clopidogrel . OBJECTIVES The aim of this study was to evaluate the impact of the phosphodiesterase ( PDE ) inhibitor pentoxifylline on platelet function profiles in patients receiving dual antiplatelet therapy ( DAPT ) . BACKGROUND Previous studies have shown that , in patients receiving DAPT , the adjunctive use of a PDE inhibitor enhances platelet inhibition , particularly in those presenting with diabetes mellitus ( DM ) . However , the pharmacodynamic ( PD ) effects of the PDE inhibitor pentoxifylline on platelet function profiles in DM patients receiving DAPT are unknown . METHODS This was a prospective , randomized , double-blind , parallel design study conducted in DM patients with stable coronary artery disease receiving DAPT . Patients were randomly assigned to either pentoxifylline 400 mg or placebo 3 times daily for 14 days . The PD effects were assessed by vasodilator-stimulated phosphoprotein phosphorylation assay , light transmittance aggregometry , VerifyNow P2Y12 assay ( Accumetric , Inc. , San Diego , California ) , and multiple electrode aggregometry at baseline and 14 days . The PD effects were also assessed according the presence or absence of high on-treatment platelet reactivity status . RESULTS A total of 40 patients were available for analysis . At 14 days , there were no differences in the P2Y ( 12 ) reactivity index as assessed by vasodilator-stimulated phosphoprotein phosphorylation between treatment groups ( primary endpoint ; p = 0.93 ) . Intra-group comparisons also failed to show any differences between baseline and 14-day P2Y ( 12 ) reactivity index assessment in the placebo and pentoxifylline arms ( p = 0.61 ) . There were no significant inter- and intra-group differences in all other PD measures . The PD effects did not vary according the presence or absence of high on-treatment platelet reactivity . CONCLUSIONS Adjunctive treatment with pentoxifylline is not associated with increased platelet inhibitory effects in DM patients with coronary artery disease receiving DAPT .
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Intervention_Pharmacological
pentoxifylline
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Intervention_Pharmacological
phosphodiesterase ( PDE ) inhibitor pentoxifylline
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Intervention_Pharmacological
PDE inhibitor
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Intervention_Pharmacological
PDE inhibitor pentoxifylline
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Intervention_Pharmacological
pentoxifylline 400 mg
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Intervention_Pharmacological
placebo
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Intervention_Control
placebo
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Intervention_Pharmacological
pentoxifylline
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Intervention_Pharmacological
pentoxifylline
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Outcome_Physical
platelet function profiles
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Outcome_Physical
platelet function profiles
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Outcome_Physical
platelet inhibition
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Outcome_Physical
platelet function profiles
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Outcome_Other
vasodilator-stimulated phosphoprotein phosphorylation assay
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Outcome_Other
light transmittance aggregometry
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Outcome_Other
VerifyNow P2Y12 assay
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Outcome_Other
San Diego , California )
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Outcome_Other
multiple electrode aggregometry
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Outcome_Physical
high on-treatment platelet reactivity status
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Outcome_Physical
P2Y ( 12 ) reactivity index
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Outcome_Physical
14-day P2Y ( 12 ) reactivity index assessment
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Outcome_Physical
PD measures
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Outcome_Physical
platelet inhibitory effects
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Participant_Condition
patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy with aspirin and clopidogrel .
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Participant_Condition
DM patients with stable coronary artery disease receiving DAPT .
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Participant_Condition
40 patients
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Participant_Condition
DM patients with coronary artery disease receiving DAPT .