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Many people have a higher chance of getting heart problems. These individuals include people who are very overweight (obesity), have high blood pressure (hypertension), diabetes, or other health concerns. Heart problems often happen because of a condition called atherosclerosis. This condition is when the arteries, which are the blood vessels carrying blood from the heart, become hard and inflamed (swollen and irritated) at the same time. Atherosclerosis causes arteries narrowing, making it harder for blood to flow through. The signs of atherosclerosis can be mild, like feeling chest pain (called angina) because the heart isn't getting enough blood. In more serious cases, it can lead to a heart attack.
Think of inflammation as the body's natural alarm system. When a person gets hurt or sick, the body releases special chemicals. These chemicals tell the immune system (the body's defence team) to come and help. Their job is to heal the injury or fight off the infection.
While inflammation is usually good, sometimes it can go wrong. Atherosclerosis is one of these conditions where the inflammation in the blood vessels becomes abnormal. This ongoing inflammation can harm the body and lead to various heart problems and other health issues not directly related to the heart.
In atherosclerosis, platelets (cell fragments in our blood that form clots and stop or prevent bleeding) bind to monocytes (a type of white blood cell and a type of phagocyte - part of the immune system) to form clusters called monocyte platelet aggregate (MPA). Studies have shown that people with atherosclerosis have higher levels of the monocytes clustering with the platelets. This aggregate contributes to the worsening of atherosclerosis. Additionally, this aggregate can predict the risk of developing various cardiac diseases.
Anti-platelet (anti-clotting) medications work by stopping platelet function. In this study, investigators are giving participants two different anti-platelet medications to study the effect of these medications on the level of MPA. The target people of our study are the people with silent atherosclerosis (there is an accumulation of lipids in the blood vessels but no signs or symptoms). No existing research demonstrates whether the two most commonly prescribed anti-platelets (aspirin and clopidogrel) can help reduce MPA levels. This study aims to show the effect of anti-platelet medications on the level of MPA and other inflammatory indicators. The two medications are aspirin and clopidogrel. These two drugs are already available in the market and widely used by different patients for different reasons. Aspirin and clopidogrel have different modes of action to stop platelet function.
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Inclusion criteria
Group 1:
Group 2:
Exclusion criteria
Group 1:
Diabetes
Receiving any anti-platelet medications within the last two weeks
Receiving any anticoagulant medications within the last two weeks
Receiving statin medications within the last two weeks
Known major organ dysfunction
Significant co-morbidities
Pregnancy or lactating woman
Unwilling, or unable to give informed consent
Presence of co-existing autoimmune disease
Hypersensitivity to aspirin or clopidogrel
Severe hepatic impairment (Child-Pugh grade C)
Active peptic ulcer
Presence of co-existing inflammatory or autoimmune diseases
Frequent use of medications known to affect platelet function five days before baseline phlebotomy and during the study
Platelet count < 100 × 109 /L or > 450 × 109 /L
Anaemia
Any known bleeding diathesis
Currently involved in other clinical research studies
Group 2:
Diabetes
Patients with PAD Rutherford category of more than 3
Receiving any anticoagulant medications within the last two weeks
Known major organ dysfunction
Pregnancy or lactating woman
Unwilling, or unable, to give informed consent
Hypersensitivity to aspirin or clopidogrel
Severe hepatic impairment (Child-Pugh grade C)
Active peptic ulcer
Presence of co-existing autoimmune disease
Frequent use of medications known to affect platelet function five days before baseline phlebotomy and during the study
Platelet count < 100 × 109 /L or > 450 × 109 /L
Anaemia
Any known bleeding diathesis
Currently involved in other clinical research studies
Primary purpose
Allocation
Interventional model
Masking
60 participants in 2 patient groups
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Central trial contact
Eman Al Musalami; Ashish Patel
Data sourced from clinicaltrials.gov
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