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Clopidogrel Therapy in Patients with Cardiovascular Disease Undergoing Transurethral Resection of the Prostate: A Step Towards Individualization

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Abstract

Objectives

The objective of this study was to test platelet function pre- and peri-operatively in clopidogrel-treated patients undergoing transurethral resection of the prostate.

Methods

This was a pilot study involving 20 male patients treated with clopidogrel (75 mg/day) for the secondary prevention of cardiovascular disease and scheduled for elective transurethral resection of the prostate. Platelet function testing with light transmittance aggregometry in platelet-rich plasma of four samples (T0, T1, T2, and T3 drawn on the same day, 3 and 7 days of clopidogrel cessation and 24-h post-operatively, respectively) was performed and evaluated in each patient. P-selectin membrane expression was evaluated using monoclonal antibodies.

Results

The platelet response to adenosine diphosphate 5 µΜ and 20 µΜ at T0 were 42 ± 15 and 60 ± 14%, respectively. After discontinuation of clopidogrel, corresponding maximum aggregation values at T1 were 60 ± 16 and 74 ± 14%, and increased to 69 ± 16 and 79 ± 18% at T2. No significant difference in platelet aggregation values were noted between T1 and T2, while similar aggregation values were recorded at T3.

Conclusions

Our findings indicate that in patients undergoing transurethral resection of the prostate, platelet activation is similar 3 and 7 days from clopidogrel cessation. These results may be of relevance in subjects at increased thrombotic risk prior to a surgical procedure carrying a high-bleeding risk.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 45110, Ioannina, Greece

    Petros Tzimas, Anastasios Petrou & Georgios Papadopoulos

  2. Department of Chemistry, Laboratory of Biochemistry, Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece

    Maria Tsoumani, Kallirroi Kalantzi, Vasileios Chantzichristos, Haralampos Milionis & Alexandros Tselepis

  3. Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Dimitrios Giannakis & Nikolaos Sofikitis

Authors
  1. Petros Tzimas
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  2. Maria Tsoumani
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  3. Dimitrios Giannakis
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  4. Kallirroi Kalantzi
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  5. Anastasios Petrou
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  6. Vasileios Chantzichristos
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  7. Nikolaos Sofikitis
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  8. Georgios Papadopoulos
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Contributions

PT, MT, AT are responsible for the study concept and design, collection and analysis of data, interpretation of results and preparation of manuscript. KK, VC, DG, NS, AP, GP and HM assisted with the study concept and design, analysis of data, interpretation of results and editing of manuscript for important intellectual content.

Corresponding author

Correspondence to Petros Tzimas.

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Ethical Approval

This study was approved by the local Ethics Committee.

Conflict of interest

Petros Tzimas, Maria Tsoumani, Dimitrios Giannakis, Kallirroi Kalantzi, Anastasios Petrou, Vasileios Chantzichristos, Nikolaos Sofikitis, Georgios Papadopoulos, Haralampos Milionis, and Alexandros Tselepis declare that they have no conflict of interest that might be relevant to the contents of this article.

Funding

No external funding was used in the preparation of this manuscript.

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Tzimas, P., Tsoumani, M., Giannakis, D. et al. Clopidogrel Therapy in Patients with Cardiovascular Disease Undergoing Transurethral Resection of the Prostate: A Step Towards Individualization. Drugs Aging 34, 917–923 (2017). https://doi.org/10.1007/s40266-017-0504-4

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  • DOI: https://doi.org/10.1007/s40266-017-0504-4

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