This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized clinical trial of the antiplatelet effects of aspirin–clopidogrel combination versus aspirin alone after lower limb angioplasty. BJS 2005; 92: 159-165.
Published: 17th December 2004
Authors: K. Cassar, I. Ford, M. Greaves, P. Bachoo, J. Brittenden
Background
There is a high risk of reocclusion after successful lower limb angioplasty. Platelets play a central role in this process. The aim of this study was to investigate the antiplatelet effect of a combination of aspirin and clopidogrel compared with aspirin alone in patients with claudication undergoing endovascular revascularization.
Method
This was a double‐blind randomized placebo‐controlled trial. Some 132 patients were randomized to clopidogrel and aspirin or placebo and aspirin, with a loading dose 12 h before endovascular intervention. Flow cytometric measurements of platelet fibrinogen binding and P‐selectin expression were taken as measures of platelet function at baseline, 12 h after the loading dose, and 1 h, 24 h and 30 days after intervention.
Results
Within 12 h of the loading dose, platelet activation in the clopidogrel group had decreased (P‐selectin by 27·3 per cent, P = 0·017; fibrinogen binding by 34·7 per cent, P = 0·024; stimulated fibrinogen binding by 49·2 per cent, P < 0·001). No change was observed in the placebo group. Platelet function in the clopidogrel group was significantly suppressed compared with baseline at 1 h, 24 h and 30 days after endovascular intervention (stimulated fibrinogen binding by 53·9, 51·7 and 57·2 per cent respectively; all P < 0·001).
Conclusion
A combination of clopidogrel and aspirin inhibited platelet function more than aspirin alone in patients with claudication before and after angioplasty. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Full text