Antiplatelet activity of carvedilol in comparison to propranolol.
The non-selective vasodilating beta-blocker carvedilol was found to inhibit platelet aggregation as well as thromboxane B(2) formation more effectively than propranolol. The antiaggregatory activity of carvedilol decreased, depending on the stimulus used, in the following rank order of potency (in parentheses the respective mean inhibitory concentrations of carvedilol and propranolol are given in micromol/l): PMA (19 and 34) > thrombin (55 and 77) > Ca(2+)-ionophore A23187 (58 and 81) > epinephrine (86 and 118). However, aggregation of platelets activated with ADP was not affected by carvedilol in concentrations up to 100 micromol/l. In platelets stimulated with thrombin, carvedilol (10 micromol/l) reduced thromboxane B(2) formation by 64%, whereas propranolol was ineffective at this concentration. Moreover, A23187-induced formation of thromboxane B(2), not affected by propranolol, was completely blocked by 100 micromol/l carvedilol. In comparison to propranolol, the molecule of carvedilol is more lipophilic and possesses lower dipole moment and higher molar refractivity, thus penetrating into platelet membranes readily and in large quantities. The antiplatelet effect was assumed to result from interactions of carvedilol with membrane macromolecules (phospholipids, ion channels, enzymes, etc.) rather than from blockade of alpha- and beta-adrenergic receptors.