Effect of Satigrel (E5510), a Novel Antiplatelet Agent, on Platelet Function and the Coagulation-Fibrinolytic System in Peripheral Arterial Occlusive Disease

A novel antiplatelet agent, satigrel (E5510), was administered to 9 patients with arteriosclerosis obliterans (ASO) and 6 patients with thromboangiitis obliterans (TAO) at a dosage of 4mg/day for 2 weeks followed by 8mg/day for another 2 weeks and its effect on platelet function and coagulation-fibrinolytic system as well as hemodynamics were evaluated. Satigrel significantly inhibited platelet aggregation induced by collagen (p<0.001), lowered plasma thromboxane B2 (TXB2) (p<0.01) and 11-dehydro TXB2 (p<0.1), and increased plasma antithrombin III (AT-III) (p<0.001). Hopwever, there were no significant change in plasma levels of β-thromboglobulin (β-TG), platelet factor 4 (PF4), 6-keto prostaglandin F1α (6-KF), thrombin-antithrombin III complex (TAT), fibrinopeptide A (FPA) and plasmin-α2 plasmin inhibitor complex (PIC). Plasma D-Dimer and fibrinopeptide Bβ15-42 (FPBβ15-42) levels were higher in ASO patients than in TAO patients before treatment and tended to increase in both groups following the administration of satigrel. Furthermore, satigrel improved tissue blood flow in the affected feet (p<0.05) even though clinical improvement and increase in ankle pressure index were not significant. These results suggest that satigrel is beneficial to a failed circulation in these arterial occlusive diseases.