JACC: Basic to Translational Science (Nov 2019)
Pharmacodynamic Effects of Vorapaxar in Patients With and Without Diabetes Mellitus
- Francesco Franchi, MD,
- Fabiana Rollini, MD,
- Victor Kairouz, MD,
- Jose Rivas Rios, MD,
- Andrea Rivas, MD,
- Malhar Agarwal, MD,
- Maryuri Briceno, MD,
- Mustafa Wali, MD,
- Ahmed Nawaz, MD,
- Gabriel Silva, MD,
- Zubair Shaikh, MD,
- Naji Maaliki, MD,
- Latonya Been, AAS,
- Jason Piraino, DPM,
- Andres M. Pineda, MD,
- Siva Suryadevara, MD,
- Daniel Soffer, MD,
- Martin M. Zenni, MD,
- Lisa K. Jennings, PhD,
- Theodore A. Bass, MD,
- Dominick J. Angiolillo, MD, PhD
Affiliations
- Francesco Franchi, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Fabiana Rollini, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Victor Kairouz, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Jose Rivas Rios, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Andrea Rivas, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Malhar Agarwal, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Maryuri Briceno, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Mustafa Wali, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Ahmed Nawaz, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Gabriel Silva, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Zubair Shaikh, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Naji Maaliki, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Latonya Been, AAS
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Jason Piraino, DPM
- Division of Foot and Ankle, Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Andres M. Pineda, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Siva Suryadevara, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Daniel Soffer, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Martin M. Zenni, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Lisa K. Jennings, PhD
- CirQuest Labs, Memphis, Tennessee
- Theodore A. Bass, MD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
- Dominick J. Angiolillo, MD, PhD
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida; Address for correspondence: Dr. Dominick J. Angiolillo, University of Florida College of Medicine–Jacksonville, 655 West 8th Street, Jacksonville, Florida 32209.
- Journal volume & issue
-
Vol. 4,
no. 7
pp. 763 – 775
Abstract
Summary: Vorapaxar reduces thrombotic cardiovascular events at the expense of increased bleeding. However, the differential pharmacodynamic (PD) effects of vorapaxar according to diabetes mellitus (DM) status are unknown. Moreover, although withdrawal of aspirin has emerged as a bleeding reduction strategy, the PD effects of stopping aspirin in patients treated with vorapaxar also are unknown. In this prospective PD investigation, vorapaxar was associated with reduced platelet-mediated thrombogenicity without affecting clot kinetics irrespective of DM status. However, platelet-mediated thrombogenicity increased after aspirin withdrawal, particularly among patients with DM. (Optimizing anti-Platelet Therapy In diabetes MellitUS-5 Study [OPTIMUS-5]; NCT02548650) Key Words: dual antiplatelet therapy, pharmacodynamics, platelets, thrombin, vorapaxar
