Lipids and Antiplatelet Therapy: Important Considerations and Future Perspectives

Int J Mol Sci. 2021 Mar 20;22(6):3180. doi: 10.3390/ijms22063180.

Abstract

Lipids play an essential role in platelet functions. It is known that polyunsaturated fatty acids play a role in increasing platelet reactivity and that the prothrombotic phenotype plays a crucial role in the occurrence of major adverse cardiovascular events. The ongoing increase in cardiovascular diseases' incidence emphasizes the importance of research linking lipids and platelet function. In particular, the rebound phenomenon that accompanies discontinuation of clopidogrel in patients receiving dual antiplatelet therapy has been associated with changes in the lipid profile. Our many years of research underline the importance of reduced HDL values for the risk of such a rebound effect and the occurrence of thromboembolic events. Lipids are otherwise a heterogeneous group of molecules, and their signaling molecules are not deposited but formed "on-demand" in the cell. On the other hand, exosomes transmit lipid signals between cells, and the profile of such changes can be monitored by lipidomics. Changes in the lipid profile are organ-specific and may indicate new drug action targets.

Keywords: HDL; P2Y12 inhibitors; discontinuation.

Publication types

  • Review

MeSH terms

  • Animals
  • Blood Platelets / drug effects*
  • Blood Platelets / metabolism*
  • Humans
  • Lipid Metabolism*
  • Lipids* / chemistry
  • Lipoproteins, HDL / metabolism
  • Platelet Aggregation / drug effects
  • Platelet Aggregation Inhibitors / chemistry
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Purinergic P2Y Receptor Antagonists / chemistry
  • Purinergic P2Y Receptor Antagonists / pharmacology
  • Purinergic P2Y Receptor Antagonists / therapeutic use

Substances

  • Lipids
  • Lipoproteins, HDL
  • Platelet Aggregation Inhibitors
  • Purinergic P2Y Receptor Antagonists