ANTIPLATELET THERAPY RESISTANCE IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION
https://doi.org/10.20996/1819-6446-2008-4-2-23-29
Abstract
Aim. To evaluate the incidence of acetylsalicylic acid (ASA) and clopidogrel resistance in patients with acute coronary syndrome with ST-segment elevation and to find out possible clinical factors, contributing to this state.
Material and methods. 58 patients with acute coronary syndrome with ST-segment elevation (49 men, 9 women) were included into the study. Age of patients ranged from 37 tо 84 y.o. (60,8±12,3 y.o. in average). Platelet aggregation was assessed by the Born’s method. Level of arachidonic acidinduced aggregation ≥20% considered as ASA resistance. Decreasing of ADP-induced platelet aggregation ≥20% considered as ASA resistance. Decreasing of ADP-induced platelet aggregation <10%, 10-29%, and ≥30% compared to the basal level considered as clopidogrel resistance, “partial clopidogrel resistance” or clopidogrel sensitiveness, respectively.
Results. ASA and clopidogrel decreased arachidonic acid-induced and ADP-induced aggregation after 7 days of the therapy compared to the basal levels (р<0,05). The highest incidence of resistance was registered in patients with diabetes mellitus (71,1% to ASA, 57,1% to clopidogrel) and obe-sity (42,9% to clopidogrel).
Conclusion. The incidence of ASA and clopidogrel resistance reached to 28,9% and 24,4% respectively in patients with acute coronary syndrome with ST-segment elevation. The prevalence of antiplatelet therapy resistance is significantly higher in patients with diabetes mellitus and obesity (р<0,05). The incidence of early complications of acute myocardial infarction is higher in patients resistant to ASA and clopidogrel.
About the Authors
D. H. Ainetdinova
Moscow Medical Academy named after I.M. Setchenov
Russian Federation
Department of faculty therapy №1
Russian Federation
Department of faculty therapy №1
A. Е. Udovichenko
Moscow Medical Academy named after I.M. Setchenov
Russian Federation
Department of faculty therapy №1
Russian Federation
Department of faculty therapy №1
V. A. Sulimov
Moscow Medical Academy named after I.M. Setchenov
Russian Federation
Department of faculty therapy №1
Russian Federation
Department of faculty therapy №1
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Review
For citations:
Ainetdinova D.H., Udovichenko A.Е., Sulimov V.A. ANTIPLATELET THERAPY RESISTANCE IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION. Rational Pharmacotherapy in Cardiology. 2008;4(2):23-29. (In Russ.) https://doi.org/10.20996/1819-6446-2008-4-2-23-29
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