http://www.ncbi.nlm.nih.gov/pubmed/26334227
Abstract
Long-term
evidence supports a clustering of cardiovascular events in the early
morning. Several studies have shown that platelet hyper-reactivity to
various stimuli is also present at this period of the day. However, the
idea of treatment strategies reflecting the circadian variation in
platelet reactivity has been largely neglected so far, and this is true
despite the huge number of patients being treated with these drugs. Some
pharmacodynamic data suggest that early-morning platelet
hyper-reactivity may be overcome by shifting aspirin intake to the
bedtime. However, there is lack of evidence whether shifting the time of
intake or splitting the daily dose of P2Y12-inhibitors with a regular
QD dosing (clopidogrel or prasugrel) to the evening would be effective
to overcome platelet hyper-reactivity or to suppress the excess of
cardiovascular events observed during morning hours. Further research is
warranted to clarify whether such a simple and costless effort like
dose shifting or splitting may be beneficial to prevent cardiovascular
events.
KEYWORDS:
ADP receptors; antiplatelet agents; antiplatelet drugs; clinical trials; platelet pharmacology- PMID:
- 26334227
- [PubMed - in process]
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