Effects of clopidogrel and prednisone on platelet function in healthy dogs

BACKGROUND: Glucocorticoids cause hypercoagulability, but it is unknown if they counteract clopidogrel's antiplatelet effects. HYPOTHESIS/OBJECTIVES: Determine the effects of clopidogrel and prednisone on platelet function. ANIMALS: Twenty‐four healthy dogs. METHODS: Double‐blinded, placebo‐con...

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Autores principales: Thomason, John, Mooney, Allison P., Price, Joshua M., Whittemore, Jacqueline C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255683/
https://www.ncbi.nlm.nih.gov/pubmed/32246893
http://dx.doi.org/10.1111/jvim.15759
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author Thomason, John
Mooney, Allison P.
Price, Joshua M.
Whittemore, Jacqueline C.
author_facet Thomason, John
Mooney, Allison P.
Price, Joshua M.
Whittemore, Jacqueline C.
author_sort Thomason, John
collection PubMed
description BACKGROUND: Glucocorticoids cause hypercoagulability, but it is unknown if they counteract clopidogrel's antiplatelet effects. HYPOTHESIS/OBJECTIVES: Determine the effects of clopidogrel and prednisone on platelet function. ANIMALS: Twenty‐four healthy dogs. METHODS: Double‐blinded, placebo‐controlled randomized trial. Platelet function was evaluated using a platelet function analyzer and impedance aggregometry (days 0, 14, and 28) for dogs treated with placebo, clopidogrel (2‐3 mg/kg/d), prednisone (2 mg/kg/d), or prednisone with clopidogrel PO for 28 days. Results were categorized as nonresponder versus responder (platelet function analyzer), and inadequate, ideal, or excessive response (aggregometry). Results were compared using mixed model, split‐plot repeated measures analysis of variance and generalized estimating equation proportional odds models. P < .05 was considered significant. RESULTS: Closure times differed by treatment (F [3, 20] = 10.5; P < .001), time (F [2, 40] = 14.3; P < .001), and treatment‐by‐time (F [6, 40] = 3.4; P = .01). Area under the curve (AUC) differed by treatment (F [3, 20] = 19.6; P < .001), time (F [2, 40] = 35.4; P < .001), and treatment‐by‐time (F [6, 40] = 13.5; P < .001). Based on closure times, 5/6 dogs each in the clopidogrel and prednisone/clopidogrel groups were responders. All dogs in the prednisone/clopidogrel group were overcontrolled based on AUC (days 14 and 28), whereas 5/6 (day 14) and 2/6 (day 28) dogs treated with clopidogrel were overcontrolled. Compared to clopidogrel, dogs receiving prednisone/clopidogrel were 11 times (P = .03) more likely to have an excessive response. CONCLUSIONS AND CLINICAL IMPORTANCE: Administration of clopidogrel/prednisone increases platelet dysfunction in healthy dogs.
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spelling pubmed-72556832020-06-01 Effects of clopidogrel and prednisone on platelet function in healthy dogs Thomason, John Mooney, Allison P. Price, Joshua M. Whittemore, Jacqueline C. J Vet Intern Med SMALL ANIMAL BACKGROUND: Glucocorticoids cause hypercoagulability, but it is unknown if they counteract clopidogrel's antiplatelet effects. HYPOTHESIS/OBJECTIVES: Determine the effects of clopidogrel and prednisone on platelet function. ANIMALS: Twenty‐four healthy dogs. METHODS: Double‐blinded, placebo‐controlled randomized trial. Platelet function was evaluated using a platelet function analyzer and impedance aggregometry (days 0, 14, and 28) for dogs treated with placebo, clopidogrel (2‐3 mg/kg/d), prednisone (2 mg/kg/d), or prednisone with clopidogrel PO for 28 days. Results were categorized as nonresponder versus responder (platelet function analyzer), and inadequate, ideal, or excessive response (aggregometry). Results were compared using mixed model, split‐plot repeated measures analysis of variance and generalized estimating equation proportional odds models. P < .05 was considered significant. RESULTS: Closure times differed by treatment (F [3, 20] = 10.5; P < .001), time (F [2, 40] = 14.3; P < .001), and treatment‐by‐time (F [6, 40] = 3.4; P = .01). Area under the curve (AUC) differed by treatment (F [3, 20] = 19.6; P < .001), time (F [2, 40] = 35.4; P < .001), and treatment‐by‐time (F [6, 40] = 13.5; P < .001). Based on closure times, 5/6 dogs each in the clopidogrel and prednisone/clopidogrel groups were responders. All dogs in the prednisone/clopidogrel group were overcontrolled based on AUC (days 14 and 28), whereas 5/6 (day 14) and 2/6 (day 28) dogs treated with clopidogrel were overcontrolled. Compared to clopidogrel, dogs receiving prednisone/clopidogrel were 11 times (P = .03) more likely to have an excessive response. CONCLUSIONS AND CLINICAL IMPORTANCE: Administration of clopidogrel/prednisone increases platelet dysfunction in healthy dogs. John Wiley & Sons, Inc. 2020-04-04 2020-05 /pmc/articles/PMC7255683/ /pubmed/32246893 http://dx.doi.org/10.1111/jvim.15759 Text en © 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle SMALL ANIMAL
Thomason, John
Mooney, Allison P.
Price, Joshua M.
Whittemore, Jacqueline C.
Effects of clopidogrel and prednisone on platelet function in healthy dogs
title Effects of clopidogrel and prednisone on platelet function in healthy dogs
title_full Effects of clopidogrel and prednisone on platelet function in healthy dogs
title_fullStr Effects of clopidogrel and prednisone on platelet function in healthy dogs
title_full_unstemmed Effects of clopidogrel and prednisone on platelet function in healthy dogs
title_short Effects of clopidogrel and prednisone on platelet function in healthy dogs
title_sort effects of clopidogrel and prednisone on platelet function in healthy dogs
topic SMALL ANIMAL
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255683/
https://www.ncbi.nlm.nih.gov/pubmed/32246893
http://dx.doi.org/10.1111/jvim.15759
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