Platelet activation in patients with congestive heart failure: Do we have enough evidence to consider clopidogrel?

Alex I. Malinin, Christopher M. O'Connor, Alec I. Dzhanashvili, David C. Sane, Victor L. Serebruany

Research output: Contribution to journalArticle

Abstract

Our understanding of the pathogenesis of congestive heart failure (CHF) has improved remarkably in recent years. However, despite better knowledge and novel pharmaceutical strategies, this disease is still one of the most brutal killers in the Western world. The pathophysiology of CHF is complex, and much of our comprehension revolves strictly around the neurohormonal and mechanical mechanisms involved. It has been suggested that CHF is associated with altered hemostasis, but whether a prothrombotic state contributes to the pathogenesis and progression of the disease is still not well known. The purpose of this review article is to discuss our current knowledge of platelet activation in patients with CHF and the potential role of antiplatelet agents in preventing these hemostatic abnormalities. Clopidogrel is an established medication that reduces the incidence of stroke, myocardial ischemia, or vascular death. It is currently the drug of choice in the prophylaxis of subacute stent thrombosis and postischemic stroke treatment. Promising results of the most resent trials (Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events [CAPRIE] and Clopidogrel in Unstable angina to prevent Recurrent Events [CURE]) may expand future indications of this ADP receptor antagonist for prevention of thrombotic complications in the CHF population. Currently conducted clinical trials (Warfarin and Antiplatelet Therapy in Chronic Heart Failure [WATCH] and Plavix Use for Treatment of Congestive Heart Failure [PLUTO-CHF] should clarify the role of clopidogrel in these patients.

Original languageEnglish (US)
Pages (from-to)397-403
Number of pages7
JournalAmerican Heart Journal
Volume145
Issue number3
DOIs
StatePublished - Mar 1 2003

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Malinin, A. I., O'Connor, C. M., Dzhanashvili, A. I., Sane, D. C., & Serebruany, V. L. (2003). Platelet activation in patients with congestive heart failure: Do we have enough evidence to consider clopidogrel? American Heart Journal, 145(3), 397-403. https://doi.org/10.1067/mhj.2003.163