Non-Responsiveness of Acetylsalicylic Acid and Clopidogrel in Peripheral Artery Disease

Abstract

Acetylsalicylic acid (ASA, aspirin) and clopidogrel, two platelet inhibitors, exerts their effects by different mechanisms. Usually, indications of use both agents in the treatment of peripheral artery disease are based on the data obtained from the sub-analyses of largescale studies in coronary artery patients. In this study, we aimed to evaluate the effects of aspirin, which is the most widely used antiplatelet agent, and clopidogrel, an alternative to aspirin in patients with peripheral artery disease. This observational, non-randomized and non-controlled singlecenter study included a total of 65 patients with documented peripheral artery disease between November 2010 and November 2009. The patients were divided into two groups as those receiving ASA 100 mg/day (Group 1, n:34) and those receiving clopidogrel 75 mg/day (Group 2, n:31). The VerifyNow® Assay was used to evaluate the responses to antiplatelet agents. Unresponsiveness was defined as an ASA reaction unit of ≥550 in Group 1 and as a platelet reaction unit of ≥234 in Group 2 patients. The rate of unresponsiveness was 8.8% in Group 1, and 22.6% in Group 2. It is well-established that both ASA and clopidogrel do not meet the expected prevention and treatment outcomes in certain cases. As the reasons for unresponsiveness have not been fully elucidated yet, search process will to be continued the prevention and treatment for micro- and macro-vascular diseases.

Keywords

• VerifyNow,Aspirin,Clopidogrel,Non-responsiveness,Peripheral Artery Disease

Periferik Arter Hastalığında Asetilsalisilik Asit ve Klopidogrel Cevapsızlığı

Abstract

İki trombosit inhibitörü olan asetilsalisilik asit (ASA, aspirin) ve klopidogrel, farklı mekanizmalarla etkilerini göstermektedir. Genellikle her iki ajanın periferik arter hastalığında kullanım endikasyonları, koroner arter hastalarında yapılan geniş çaplı çalışmaların alt-analizlerinden elde edilen verilere dayanmaktadır. Bu çalışmada, en sık kullanılan antiplatelet ajan olan aspirinin ve periferik arter hastalığı olan hastalarda aspirine alternatif klopidogrelin etkilerini araştırmayı amaçladık. Bu gözlemsel, non-randomize ve kontrolsüz tek merkezli olan çalışma, Kasım 2010 ile Kasım 2009 tarihleri arasında dökümente periferik arter hastalığı olan toplam 65 hastayı kapsamaktadır. Hastalar, ASA 100 mg / gün (Grup 1, n: 34) alanlar ve Klopidogrel 75 mg / gün alanlar (Grup 2, n: 31) olmak üzere iki gruba ayrıldı. VerifyNow® Testi, anti-platelet ajanlara verilen yanıtları değerlendirmek için kullanıldı. Cevapsızlık, Grup 1’de ASA reaksiyon ünitesi ≥ 550 ve Grup 2’de Trombosit reaksiyon ünitesi ≥ 234 olarak tanımlandı. Cevapsızlık, Grup 1 hastalarında %8,8; Grup 2 hastalarında %22,6 bulundu. Bazı durumlarda ASA ve klopidogrelin her ikisinin de beklenen önleme ve tedavi sonuçlarını karşılamadığı iyi belirlenmiştir. Cevapsızlık nedenleri henüz tam olarak aydınlatılamadığından, mikro ve makro vasküler hastalığın önlenme ve tedavisinde arayış süreci devam edecektir. 

Keywords

• VerifyNow,Aspirin,Klopidogrel,Cevapsızlık,Periferik Arter Hastalığı

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