Which drugs affect platelet microparticle levels

Platelet microparticles (PMPs) are one of the markers of platelet activation. In recent years, studies have shown that antiplatelet agents, hypoglycemic agents, and lipid-regulating agents have an effect on the level of PMP.

Aspirin, an antiplatelet drug: The mechanism by which aspirin reduces PMP is not very clear. It may be related to the inhibition of cyclooxygenase by aspirin, or may be related to the time of taking the drug.

ADP receptor antagonists: Studies have found that plasma clopidogrel levels are negatively correlated with PMP levels, ie clopidogrel is able to reduce PMP levels, and the degree of reduction is related to clopidogrel concentrations. In addition, when combined with aspirin, clopidogrel can still exert additional anti-platelet and PMP-lowering effects based on the action of aspirin. In addition to clopidogrel, Kagawa and Serebruany found that ticlopidine and prasugrel also inhibit the production of PMP.

Glycoprotein IIb/IIIa Receptor Antagonists: Studies have shown that abciximab inhibits platelet activation, which in turn reduces PMP release. Another study showed that abciximab, tirofiban, and eptifibatide, three glycoprotein IIb/IIIa antagonists, inhibit platelet aggregation in a similar manner, but their ability to inhibit platelet activation differs. . Abciximab's superior ability to inhibit platelet activation may be related to its inhibition of P-selectin transposition and vWF-mediated platelet activation.

The hypoglycemic agent acarbose can effectively reduce postprandial blood glucose, which in turn can effectively reduce plasma levels of PMP. In addition, acarbose can increase plasma adiponectin levels in diabetic patients, while adiponectin stimulates NO production in vascular endothelial cells, thereby inhibiting platelet activation and reducing PMP production. Acarbose reduces plasma PMP levels in diabetic patients, improves blood hypercoagulability, and high platelet aggregation rates, which may be beneficial in reducing atherosclerotic thrombosis in diabetic patients.

Lipid-regulating statin drugs: The mechanism of simvastatin lowering PMP may be related to the decrease of LDL levels, because the researchers found that LDL levels are positively correlated with PMP levels in all patients. Simvastatin significantly LDL levels have been reduced, and PMP levels have also dropped significantly. Another study found that pitavastatin did not significantly reduce plasma PMP levels in patients with type 2 diabetes mellitus and hyperlipidemia, but could significantly enhance the role of eicosapentaenoic acid in reducing PMP levels in these patients. Pitavastatin is related to the effect of elevated adiponectin.

Fibrate drugs: Kagawa et al. applied bezafibrate to 22 patients with secondary hyperlipidemia due to long-term steroid use of connective tissue disease. After 6 months, triglycerides and total cholesterol decreased, and PMP levels also decreased. Significantly lower. Therefore, bezafibrate may be beneficial in inhibiting vascular injury associated with PMP in patients with connective tissue disease secondary to hyperlipidemia.