Isparta ve çevresinde klopidogrel direncinin araştırılması

Abstract

Giriş ve amaç: Akut koroner sendrom (AKS) ile başvuran ve/veya stent uygulanan hastalarda klopidogrel 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. Klopidogrel direncini saptamak için pratik, kolay uygulanabilinir, ucuz ve güvenilir parametrelere ihtiyaç vardır.

Materyal-Metot: Akut Koroner Sendrom tanısı ile klopidogrel kullanan 531 hasta çalışmaya alındı. Alınan kan örneklerinde MEA (multiple electrod aggregometry) ile çalışıldı. Sonuçlar eğri altında kalan alan (AUC) cinsiden verildi. AUC > 470 olması klopidogrel direci,  olarak yorumlandı.

Bulgular:       Toplamda 65  (% 12,2)  hastada klopidogrel direnci saptandı. Kadın hastalarda klopidogrel direnci anlamlı olarak fazlaydı (P= 0,005). Risk faktörlerine bakıldığında ise hiperlipidemik ve diyabetik hastalarda klopidogrel direnci daha fazla görülürken, sigara içenlerde direnç daha az görülmekteydi (p= 0,016, p< 0,001, p= 0,046). Klopidogrel direnci olan hastalarda kalsiyum seviyesi, trombosit sayısı ve vücut kitle indeksi daha yüksek bulundu.   

Sonuç: Bu çalışma, vücut kitle indeksi, diyabet, hiperlipidemi, kadın cinsiyet’in klopidogrel direnci açısından bir risk faktörü olabileceğini ortaya koymuştur. 

Keywords

• Akut koroner sendrom,klopidogrel direnci,Isparta

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