Comparing antiplatelet effects of acetylsalicylic acid in different forms
Lomakin N. V., Rusanova A. V., Buryachkovskaya L. I., Vershinina M. G.
Keywords: antiaggregates, acetylsalicylic acid, coronary heart disease, treatment
Background. Reducing risk for thrombotic complications in IHD patients remains a relevant issue of current pharmacotherapy. Acetylsalicylic acid (ASA) is a first-line drug which keeps a leading place in all guidelines on managing IHD patients. ASA is available in two different forms, the enteric-coated form (enteric) which absorbs in the small intestine, and the form absorbing in the stomach, which contains a non-absorbing antacid (buffered). Despite extensive experience of using ASA, the issue on antiplatelet effects of different ASA forms remains open. Aim. To compare antiplatelet activities of enteric ASA (Thrombo ASS) and ASA + magnesium hydroxide (buffered form, Cardiomagnyl) in stable patients with cardiovascular disease. Materials and methods. This monocenter randomized study included 60 patients (24 males and 36 females) aged 42 to 92 years with stable cardiovascular disease who had indications for ASA in cardioprotective doses according to current guidelines. Parameters of platelet functional activity were tested for 7 days during the buffered ASA (Cardiomagnyl, 75 mg / day, 26 patients) or enteric ASA (Thrombo ASS, 100 mg / day, 33 patients) treatment. Results. The 7day treatments with different ASA forms resulted in significantly decreased platelet aggregation induced by both low (1.0 µМ) and high (5.0 µM) ADP doses, and recovery of the disaggregation phenomenon. During the Cardiomagnyl treatment, platelet activity was significantly reduced compared to the Thrombo ASS treatment. In the group of patients receiving Thrombo ASS, cases of resistance to the medication were observed significantly more frequently than in the Cardiomagnyl treatment group. Cardiomagnyl reduced levels of thromboxane B2 significantly more potently than Throbo ASS (54.4 and 34.7 %, respectively). Conclusion. The compared ASA forms differed by their antiplatelet activities. The buffered ASA form (Cardiomagnyl) exerted a more pronounced antiplatelet effect which was associated with lower resistance than with the enteric-soluble form (Thrombo ASS).
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Lomakin N. V., Rusanova A. V., Buryachkovskaya L. I. et al. Comparing antiplatelet effects of acetylsalicylic acid in different forms. Russian Heart Journal. 2014;78 (4):206–214