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

Year 2017, Volume: 1 Issue: 3, 97 - 103, 29.12.2017

Elif Coşkun Veli Yıldırım İmren

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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