Journal of Cardiovascular Translational Research

, Volume 7, Issue 1, pp 39–46

Impact of Mild Hypothermia on Platelet Responsiveness to Aspirin and Clopidogrel: an In Vitro Pharmacodynamic Investigation

Authors

    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • José Carlos Sánchez-Salado
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Montserrat Gracida
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Ana Lucrecia Marcano
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Gerard Roura
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Albert Ariza
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Josep Gómez-Lara
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Victoria Lorente
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Rafael Romaguera
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Sílvia Homs
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Guillermo Sánchez-Elvira
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Luis Teruel
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Kristian Rivera
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Silvia Gabriela Sosa
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Joan Antoni Gómez-Hospital
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
  • Dominick J. Angiolillo
    • University of Florida College of Medicine-Jacksonville
  • Ángel Cequier
    • Heart Diseases Institute, Bellvitge University Hospital—IDIBELLUniversity of Barcelona
Article

DOI: 10.1007/s12265-013-9533-5

Cite this article as:
Ferreiro, J.L., Sánchez-Salado, J.C., Gracida, M. et al. J. of Cardiovasc. Trans. Res. (2014) 7: 39. doi:10.1007/s12265-013-9533-5

Abstract

The combination of percutaneous coronary intervention (PCI) and therapeutic hypothermia in comatose patients after cardiac arrest due to an acute coronary syndrome has been reported to be safe and effective. However, recent investigations suggest that hypothermia may be associated with impaired response to clopidogrel and greater risk of thrombotic complications after PCI. This investigation aimed to evaluate the effect of hypothermia on the pharmacodynamic response of aspirin and clopidogrel in patients (n = 20) with ST elevation myocardial infarction undergoing primary PCI. Higher platelet reactivity (ADP stimulus) was observed in samples incubated at 33 °C compared with those at 37 °C (multiple electrode aggregometry, 235.2 ± 31.4 AU×min vs. 181.9 ± 30.2 AU×min, p < 0.001; VerifyNow P2Y12, 172.9 ± 20.3 PRU vs. 151.0 ± 19.3 PRU, p = 0.004). Numerically greater rates of clopidogrel poor responsiveness were also observed at 33 °C. No differences were seen in aspirin responsiveness. In conclusion, mild hypothermia was associated with reduced clopidogrel-mediated platelet inhibition with no impact on aspirin effects.

Clinical relevance: Mild therapeutic hypothermia is associated with impaired response to clopidogrel therapy, which might contribute to increase the risk of thrombotic events in ACS comatose patients undergoing PCI.

Keywords

Therapeutic hypothermiaAntiplatelet therapyST elevation myocardial infarction

Copyright information

© Springer Science+Business Media New York 2013