Serebruany Victor L, Malinin Alex I, Sane David C
Sinai Hospital, Johns Hopkins University, Baltimore, Maryland 21215, USA.
Am J Hematol. 2003 Apr;72(4):280-1. doi: 10.1002/ajh.10290.
Aggrenox is a novel combination of 25 mg of aspirin with 200 mg of sustained release dipyridamole. In a recent large trial (ESPS-2), Aggrenox was twice as effective for secondary stroke prevention as either aspirin or dipyridamole alone, suggesting superior platelet inhibition for combination therapy. We sought to compare the time course of platelet inhibition with Aggrenox compared with escalating doses of non-enteric coated aspirin. Data from 10 healthy volunteers were analyzed. Fasting subjects sequentially ingested aspirin in the following order: 325 mg, 81 mg, 25 mg, and then one pill of Aggrenox after a 3-week interval for aspirin washout. Platelet function was assessed at baseline, 15, 30, 60, and 120 min post-medication with 5 microM epinephrine and 5 microM ADP using conventional aggregometry. Aspirin provided significant (P < 0.01) reduction of platelet aggregation at 15 min post 325 mg, 30 min post 81 mg, and unexpectedly within 60 min after taking 25 mg of aspirin. A single pill of Aggrenox also inhibited platelet aggregation within 1 hr after administration. Aspirin inhibits platelets remarkably fast. Both Aggrenox and a matching dose of aspirin (25 mg) exhibit significant antiplatelet properties within 60 min after ingestion. These findings could be relevant for the optimal balance between the reduction of vascular events via sufficient and rapid platelet inhibition and low risk of bleeding complications associated with the Aggrenox therapy.
安克洛（Aggrenox）是一种新型复方制剂，由25毫克阿司匹林与200毫克缓释双嘧达莫组成。在最近一项大型试验（ESPS - 2）中，安克洛在二级卒中预防方面的效果是单独使用阿司匹林或双嘧达莫的两倍，这表明联合治疗具有更强的血小板抑制作用。我们试图比较安克洛与递增剂量的非肠溶阿司匹林在血小板抑制时间进程上的差异。分析了10名健康志愿者的数据。空腹受试者按以下顺序依次服用阿司匹林：325毫克、81毫克、25毫克，然后在经过3周的阿司匹林洗脱期后服用一片安克洛。在用药后15、30、60和120分钟，使用传统的凝集测定法，用5微摩尔肾上腺素和5微摩尔二磷酸腺苷评估血小板功能。服用325毫克阿司匹林后15分钟、81毫克后30分钟以及服用25毫克阿司匹林后60分钟内，血小板聚集均有显著（P < 0.01）降低。服用一片安克洛后1小时内也能抑制血小板聚集。阿司匹林抑制血小板的速度非常快。安克洛和相同剂量的阿司匹林（25毫克）在摄入后60分钟内均表现出显著的抗血小板特性。这些发现可能与通过充分且快速的血小板抑制来降低血管事件与安克洛治疗相关的低出血并发症风险之间的最佳平衡有关。
