Inhibition of platelet function with clopidogrel is associated with a reduction of inflammation in patients with peripheral artery disease

Background: The reactivity of platelets is increased in patients with peripheral artery disease (PAD). RANTES and sCD40L are chemokines which are stored in the alpha-granules of platelets. Clopidogrel inhibits and thus reduces platelet reactivity. Whether a treatment with clopidogrel is associated with an inhibition of systemic inflammation in patients with PAD has not been thoroughly explored. This study examined the effect of clopidogrel on platelet reactivation and the release of inflammatory chemokines in patients with PAD. Methods: 40 patients with PAD were randomized into two groups. In the first group A the patients were treated with 100 mg acetylsalicylic acid (ASA) and additional placebo for 4 weeks. The patients in group B received 75 mg/d clopidogrel in addition to ASA 100mg for 4 weeks. After obtaining blood at days 0, 7 and 28 the platelet activation was determined by measuring the surface protein expression of CD63, CD62p and thrombospondin (TSP) after stimulation with TRAP and ADP. The release of the chemokines RANTES and sCD40L from platelets was analyzed by ELISA. Results: Platelet activation markers (CD62p and CD63) and chemokine RANTES were significantly reduced in patients with PAD after 7 and 28 days after treatment with clopidogrel. No alterations were found in TSP expression and sCD40L during the treatment. Conclusion: The treatment with clopidogrel leads to a reduction of platelet reactivity and release of RANTES from the platelets of patients with PAD. (C) 2016 Elsevier Inc. All rights reserved.