Investigation of acetylsalicylic acid resistance in patients with acute coronary syndrome

Yıl 2019, , 167 - 171, 16.06.2019

Fatih Aksoy , Hasan Aydın Baş , Ali Bağcı , Ercan Varol , Ahmet Altınbaş

https://doi.org/10.22312/sdusbed.539426

Öz

Background: Aspirin and clopidogrel therapy is the standard
of care in patients with acute coronary syndrome (ACS) and stent implantation.
However, Clopidogrel and aspirin resistance are arising increasingly. As this
nonresponsiveness is associated with increased adverse outcome, detection of
these subjects in daily practice is important in order to withhold a more aggressive
therapy and closer follow up. The platelet function tests for measurement
aspirin and clopidogrel resistance are very expensive and time consuming. We
need have practically, easily accessible, cheaper and reliable parameters for
detecting aspirin and clopidogrel resistance

Methods: A total of 541 patients who had been on
clopidogrel and aspirin therapy for the diagnosis of acute coronary syndrome
were enrolled in this study. Aspirin resistance was analyzed by Multiplate
MP-0120 device by using the method of whole blood aggregometry. The amount of
ADP induced platelet aggregation was assessed as area under curve (AUC), and a
cut off value of 500 for aspirin resistance, above which the patient is
considered as aspirin resistant, was used.

Results:  Among
the 541 patients analyzed, 45 were found aspirin nonresponder (8.5%). Diabetes
Mellitus, Hyperlipidemia, calcium levels, platelet levels, were predictory
factor for aspirin resistance.

Conclusion: This study showed that diabetes mellitus,
hyperlipidemia, calcium levels, platelet levels are associated with aspirin resistance
especially in patients with ACS.

Anahtar Kelimeler

aspirin resistance, acute coronary syndrome, risk factors

Akut Koroner Sendrom ile Başvuran Hastalarda Asetil Salisilik Asit Direncinin Araştırılması

Öz

Giriş ve amaç:
Akut koroner sendrom (AKS) ile başvuran ve/veya stent uygulanan hastalarda
klopidogrel ve aspirin tedavisi günümüzde standart tedavidir. Bununla beraber
klopidogrel tedavisine yanıtsızlık olumsuz sonuçlarla ilişkili olması nedeni
ile günümüzde önemli bir sorundur. Antitrombositer ilaçların etkinliğini ölçmek
için kullanılan trombosit fonksiyon testleri çoğu kez pahalı, zaman alıcı ve
ulaşılması zor testlerdir. Aspirin ve klopidogrel direncini saptamak için
pratik, kolay uygulanabilinir, ucuz ve güvenilir parametrelere ihtiyaç vardır.

Metot: Akut
Koroner Sendrom tanısı ile klopidogrel ve aspirin kullanan 531 hasta çalışmaya
alındı. Alınan kan örneklerinde MEA (multiple electrod aggregometry) ile
çalışıldı. Sonuçlar eğri altında kalan alan (AUC) cinsiden verildi. AUC>500
olması aspirin direnci olarak yorumlandı.

Bulgular:       Toplamda 45  (%8,5) hastada ise aspirin direnci
saptandı.  Aspirin direnci için ise
diyabet, hiperlipidemi, ürik asit düzeyi, LDL kolesterol düzeyi, non-HDL
kolesterol düzeyi, kalsiyum düzeyi, trombosit sayısı, risk faktörü olarak
tespit edildi.

Sonuç: Bu çalışma;
Diyabet, hiperlipidemi, LDL kolesterol düzeyi, non-HDL kolesterol düzeyi,
kalsiyum düzeyi, trombosit sayısı, aspirin direncini ön görmede
kullanılabilecek bir parametre olduğunu gösterdi. 

Anahtar Kelimeler

Aspirin direnci, akut koroner sendrom, risk faktörleri

Kaynakça

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