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Cited by 16Antiplatelet Therapy and Cardiovascular DiseasesPlatelet Disorders and TreatmentsBlood Coagulation and Thrombosis Mechanisms

Effects of Carvedilol Versus Metoprolol on Platelet Aggregation in Patients With Acute Coronary Syndrome: The PLATE-BLOCK Study

Ilardi, Federica, Gargiulo, Giuseppe, Schiattarella, Gabriele Giacomo, Giugliano, Giuseppe, Paolillo, Roberta, Menafra, Giovanni, De Angelis, Elena, Scudiero, Laura +8 more·2018·The American Journal of Cardiology
DOI 10.1016/j.amjcard.2018.03.004
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Abstract

Platelet aggregation plays a pivotal role in acute coronary syndrome (ACS). In this setting, β-blockers (BBs) are used to counteract the effects of catecholamines on heart. Circulating catecholamines can also potentiate platelet reactivity, mainly through α 2- and β 2-adrenoceptors on human platelets' surface, thus BB may affect platelet aggregation; however, the effects of different BBs on platelet aggregation in contemporary-treated patients with ACS have been poorly investigated. One hundred patients with ACS on dual antiplatelet therapy with aspirin and ticagrelor were randomized to receive treatment with carvedilol, a nonselective BB (n = 50), or metoprolol, a selective β 1-blocker (n = 50), at maximum tolerated dose. Light transmission aggregometry was performed at randomization (T0) and at 30-day follow-up (T30), and the results were expressed as a percentage of maximum platelet aggregation (MPA). The primary end point was epinephrine-induced MPA at 30 days. Patients were predominantly men (80%), and mean age was 57.3 ± 9.7 years. The 2 randomized groups were well balanced for baseline characteristics. At T0, mean MPA was similar between the groups (18.96 ± 9.05 vs 18.32 ± 9.21 with 10 µM epinephrine, 14.42 ± 9.43 vs 15.98 ± 10.08 with 20 µM adenosine diphophate (ADP), and 13.26 ± 9.83 vs 14.30 ± 9.40 with 10 µM ADP for carvedilol and metoprolol, respectively, all p = NS). At 30 days, platelet aggregation induced by epinephrine was significantly lower in the carvedilol group than in the metoprolol group (23.52 ± 10.25 vs 28.72 ± 14.37, p = 0.04), with a trend toward the lower values of ADP-induced MPA (20 µM ADP 19.42 ± 13.84 vs 24.16 ± 13.62, p = 0.09; 10 µM ADP 19.12 ± 12.40 vs 22.57 ± 13.59, p = 0.19). In conclusion, carvedilol, a nonselective BB, reduces residual platelet reactivity in patients with ACS compared with the selective BB, metoprolol.

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Authors
Ilardi, F., Gargiulo, G., Schiattarella, G. G., Giugliano, G., Paolillo, R., Menafra, G., De Angelis, E., Scudiero, L., Franzone, A., Stabile, E., Perrino, C., Cirillo, P., Morisco, C., Izzo, R., Trimarco, V., & Esposito, G.
Affiliations
  • Federico II University Hospital (IT)
  • University Hospital of Bern (CH)
  • University of Naples Federico II (IT)
Corresponding author
Esposito, Giovanni
ORCID
Venue
The American Journal of Cardiology
Publisher
Elsevier BV
Published
2018-07
Volume
122
Issue
1
Pages
6-11
ISSN
0002-9149 (ISSN-L)
DOI
10.1016/j.amjcard.2018.03.004
OpenAlex
W2796164561
Cited by
16
References
31
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2022: 2 · 2021: 4 · 2020: 4 · 2018: 2
FWCI
1.89
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (submittedVersion)
  • CINECA IRIS Institutional Research Information System (University of Basilicata) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
  • Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Keywords
carvedilol, metoprolol, platelet aggregation, acute coronary syndrome, beta-blockers, epinephrine-induced aggregation, ADP-induced aggregation, catecholamines, dual antiplatelet therapy, ticagrelor, aspirin, platelet reactivity, beta-1 selectivity, non-selective beta-blockers, antiplatelet therapy
MeSH terms
Carvedilol, Blood Platelets, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Male, Metoprolol, Middle Aged, Platelet Aggregation, Platelet Function Tests, Prospective Studies, Treatment Outcome, Acute Coronary Syndrome, Adrenergic alpha-1 Receptor Antagonists, Adrenergic beta-1 Receptor Antagonists

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