Influence on lipoprotein metabolism of the platelet inhibitory drug ticlopidine.

The influence of the platelet inhibitory drug Ticlopidine (T) (500 mg daily) on lipoprotein metabolism was investigated in a double-blind placebo-controlled study of 38 middle-aged men with incapacitating stable angina pectoris. The concentrations of cholesterol (C), phospholipid (PL) and triglyceride (TG) in plasma, and very low density (VLDL), low density (LDL) and high density lipoprotein (HDL) fractions were measured before and after 4 and 8 weeks of treatment. After 8 weeks of T treatment the levels of C, PL and TG were increased by 14%, 15% and 30%, respectively. These elevations were confined to the atherogenic VLDL and LDL fractions. The LDL level showed a continuous increase during the study. There were no changes in the HDL fraction. The present findings emphasize the necessity to investigate several risk factors in all attempts of prevention of atherosclerotic disease. Before and during long-term treatment with T monitoring of plasma lipoprotein levels are recommended.