Nitroaspirin plus clopidogrel versus aspirin plus clopidogrel against platelet thromboembolism and intimal thickening in mice

Stefania Momi; Simon C. Pitchford; Paolo F. Alberti; Pietro Minuz; Piero Del Soldato; Paolo Gresele

doi:10.1160/TH04-07-0464

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(03): 535-543
DOI: 10.1160/TH04-07-0464

Platelets and Blood Cells

Schattauer GmbH

Nitroaspirin plus clopidogrel versus aspirin plus clopidogrel against platelet thromboembolism and intimal thickening in mice

Stefania Momi

¹Department of Internal Medicine, Section of Internal and Cardiovascular Medicine

,

Simon C. Pitchford

¹Department of Internal Medicine, Section of Internal and Cardiovascular Medicine

,

Paolo F. Alberti

²Department of Experimental Medicine and Biochemical Science, Section of Pathological Anatomy, University of Perugia, Perugia, Italy

,

Pietro Minuz

³University of Verona, Department of Biomedical and Surgical Sciences, Verona, Italy

,

Piero Del Soldato

⁴Nicox Research Institute, Milan, Italy

,

Paolo Gresele

¹Department of Internal Medicine, Section of Internal and Cardiovascular Medicine

› Author Affiliations

Abstract

Summary

Clopidogrel plus aspirin is the treatment of choice for patients undergoing percutaneous, coronary interventions with stenting, but it does not prevent restenosis. NCX-4016, a nitric oxide-releasing aspirin (nitroaspirin), exerts a wider range of antiplatelet actions compared to aspirin, superior antithrombotic activity and reduces restenosis after arterial injury in animals. The aim of the present study was to compare the combination of nitroaspirin plus clopidogrel with aspirin plus clopidogrel in a model of platelet pulmonary thromboembolism, bleeding and intimal thickening in mice. Drugs were administered orally for 5 days; the antithrombotic effects were evaluated against collagen plus epinephrine-induced pulmonary thromboembolism, the haemorrhagic effects by tail transection bleeding time and the effects on neointima proliferation by histomorphology of photochemically injured femoral arteries. Lung platelet emboli were reduced significantly and more effectively by nitroaspirin plus clopidogrel (-56%, p< 0.05 vs control) than by aspirin plus clopidogrel (-26%, p< 0.05 vs control). Ex vivo platelet aggregation was inhibited maximally by nitroaspirin plus clopidogrel. Aspirin plus clopidogrel strikingly prolonged the bleeding time while nitroaspirin plus clopidogrel induced a lesser prolongation. Nitroaspirin plus clopidogrel significantly reduced intimal thickening of the femoral artery while aspirin plus clopidogrel was ineffective. Nitroaspirin plus clopidogrel is more effective and less prohaemorrhagic than aspirin plus clopidogrel in mice; provided these data are confirmed in other animal models, nitroaspirin plus clopidogrel may represent a new regimen to be tested in patients undergoing coronary revascularization procedures.

Keywords

Nitric oxide - platelet aggregation - pulmonary thromboembolism - restenosis - thromboxane

Full Text

References

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