Discussions that mention ticlopidine

Heart Disorders board

One of my sources Cleveland Clinic, vol 69, No. 5; May 2002 and contibutors:

. Gum PA, Kottke-Marchant K, Poggio ED, et al. Profile andprevalence of aspirin resistance in patients with cardio-vascular disease. (CAPRIE). Lancet 1996; 348:1329–1339.8. Bhatt DL, Hirsch AT, Ringleb PA, et al. Reduction in theneed for hospitalization for recurrent ischemic events andbleeding with clopidogrel instead of aspirin. Am Heart J2000; 140:67–73.9. Bhatt DL, Chew DP, Hirsch AT, et al. Superiority of clopi-dogrel versus aspirin in patients with prior cardiacsurgery. Circulation 2001; 103:363–368.10. Muller C, Buttner HJ, Petersen J, et al. A randomizedcomparison of clopidogrel and aspirin versus ticlopidineand aspirin after the placement of coronary-artery stents.Circulation 2000; 101:590–593.11. Taniuchi M, Kurz HI, Lasala JM. Randomized comparisonof ticlopidine and clopidogrel after intracoronary stentimplantation in a broad patient population.combination with aspirin after coronarystenting: the Clopidogrel Aspirin Stent InternationalCooperative Study (CLASSICS). Circulation 2000;102:624–629.13. Mehta SR, Yusuf S, for CURE Study Investigators. TheClopidogrel in Unstable angina to prevent RecurrentEvents (CURE) trial programme; rationale, design andbaseline characteristics including a meta-analysis of theeffects of thienopyridines in vascular disease. Eur Heart J2000; 21:2033–2041.14. Mehta SR, Yusuf S, Peters RJ, et al. Effects of pretreat-ment with clopidogrel and aspirin followed by long-termtherapy in patients undergoing percutaneous coronaryintervention: the PCI-CURE study. Lancet 2001;358:527–533.15. Steinhubl SR, Ellis SG, Wolski K, et al. Ticlopidine pre-treatment before coronary stenting is associated with sus-tained decrease in adverse cardiac events: data from theEvaluation of Platelet IIb/IIIa Inhibitor for Stenting (EPIS-TENT) Trial. Circulation 2001; 103:1403–1409.16. Chew DP, Bhatt DL, Robbins MA, et al. Effect of clopido-grel added to aspirin before percutaneous coronary inter-vention on the risk associated with C-reactive protein. AmJ Cardiol 2001; 88:672–674.ADDRESS: Deepak L. Bhatt, MD, Department of CardiovascularMedicine, F25, The Cleveland Clinic Foundation, 9500 EuclidAvenue.

For a common understanding CURE is a study of the effects of Clopidogrel (Clop) in acute coronary syndrome (unstable angina) without ST segment elevation patients and the efficacy before and after PCI.

Clop inhibits platelet activation through the adenosine diphosate pathway via a different route than aspirin does, combination in therapy with aspirin may offer benefits over either drug alone...aspirin inhibits platelet aspirin activation through the thromboxide A2 pathway, but does not effect activation through the adenosine diphosate or thrombin pathways."

"The CURE study demonstrated long-term Clop therapy to be superior to placebo in high-risk patients presented with acute coronary syndromes without ST-segment elevation. This is an impressive result since the benefit is in addition to that of aspirin"

Source: American College of Cardiology, March 19, 2001.
"Early and long-termuse of clop is found to be beneficial in patients with unstable angina and non Q-wave (older term for elevated st-segment) myocardial infarction (mild heart attack)...the benefit of clop was seen within 2 hours of treatment and continuoulsy increased over the entire study of 12 months."

Medscape Today, January 10, 2006 (note this fairly recent)

"The benefit of therapy with clop. in addition to aspirin in patients presenting with NSTE ACSs was significant irrespective of the timing of PCI. The combination of clop. and an early (less than 48 hours) intervention strategy was associated with low absolute event rates for CV death/non fatal MI."

PubMed.gov, August 18, 2001
CAPRIE is a study for Plavix vs aspirin. Conclusion: "Long-term administration of clop to patients with atherosclerosis vascular disease is more effective than aspirin in reducing the combined risk of ischemic stroke, MI, or vascular death. The overall safety profile of clop. is at least as good as that of a medium does of aspirin."

etc. etc. etc.