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Two Mechanistic Pathways for Thienopyridine-Associated Thrombotic Thrombocytopenic Purpura

A Report From the SERF-TTP Research Group and the RADAR Project

Charles L. Bennett, MD, PhD^_*,_*, Benjamin Kim, MD^_*, Anaadriana Zakarija, MD^_*, Nicholas Bandarenko, MD, Dilip K. Pandey, MBBS, MS, PhD, Charlie G. Buffie, BA^_*, June M. McKoy, MD, MPH, JD^_*, Amul D. Tevar, MPH, John F. Cursio, MS, Paul R. Yarnold, PhD^_*, Hau C. Kwaan, MD, PhD, Davide De Masi^_*, Ravindra Sarode, MD^||, Thomas J. Raife, MD, Joseph E. Kiss, MD^¶, Dennis W. Raisch, PhD^_**, Charles Davidson, MD, FACC^_*, J. Evan Sadler, MD, PhD, Thomas L. Ortel, MD, PhD, X. Long Zheng, MD, PhD, Seiji Kato, PhD^¶¶, Masanori Matsumoto, MD, PhD^¶¶, Masahito Uemura, MD, PhD^¶¶ and Yoshihiro Fujimura, MD, PhD^¶¶

^_* VA Center for Management of Complex Chronic Care at Jesse Brown VA Medical Center, Divisions of Hematology/Oncology, Geriatric Medicine, Emergency Medicine, and Cardiology, Department of Medicine, and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
University of North Carolina, Chapel Hill, North Carolina
Department of Neurology and Rehabilitation, University of Illinois Medical Center at Chicago, Chicago, Illinois
University of Iowa, Iowa City, Iowa
^¶ University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
^|| University of Texas Southwestern Medical Center, Dallas, Texas
^_** VA Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, University of New Mexico, Albuquerque, New Mexico
Washington University, St. Louis, Missouri
Duke University Medical Center, Durham, North Carolina
The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
^¶¶ Nara Medical University, Kashihara, Japan.

View larger version (11K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Duration of Thienopyridine Exposure Prior to TTP Onset (A) Thienopyridine-associated thrombotic thrombocytopenic purpura (TTP) onset: ticlopidine versus clopidogrel (p = 0.0016). (B) Thienopyridine-associated TTP onset: ADAMTS13 deficient versus ADAMTS13 nondeficient (p > 0.05).