ACETYLSALICYLIC ACID RESISTANCE IN PATIENTS WITH ACUTE CORONARY SYNDROME AND ITS RELATIONSHIP BETWEEN MEAN PLATELET VOLUME

Öz

Objective: Insufficient biochemical response to Acetylsalicylic Acid (ASA) is defined as 'ASA resistance'. Its prevalence is unknown. The frequency of death and cardiovascular events rises as the mean platelet volume (MPV) increases in patients with acute coronary syndrome (ACS). Patients with high MPV are more resistant to antiplatelet agents. Our study aimed to evaluate the temporal variability of ASA resistance and platelet reactivity in ACS patients and to demonstrate its relationship with MPV. Material and Methods: Our study is single-center prospective, cross-sectional study. Patients over 18 years of age who were hospitalized due to ACS and underwent percutaneous coronary intervention were included. ASA resistance and MPV measurements were taken at admission and first month. The prevalence and alteration of ASA resistance and its relationship with MPV were analyzed. Results: 115 patients were included in the study. 7 patients (6.08%) were ASA-resistant at first admission and increased to 22 (19.13%) at the 1st month follow-up (p=0.003). A significant numerical increase in ASA resistance was observed in the first month of controls (p<0.01). The prevalence of ASA resistance was calculated as 22.6%. MPV was found to be high in 16 patients (13.9%) at the time of admission, while it was found to be high in 15 patients (13.04%) at the 1-month follow-up (p=0.98). MPV values were found to be similar in patients with and without ASA resistance. Conclusion: ASA resistance is more common than thought. Therefore, evaluating platelet functions in predicting the clinical outcomes of patients is important in determining the effectiveness of the antiplatelet agent used.

Anahtar Kelimeler

• Acute coronary syndrome
• acetylsalicylic acid
• mean platelet volume

Akut Koroner Sendrom Hastalarında Asetilsalisilik Asit Direnci ve Ortalama Platelet Hacmi ile İlişkisi

Öz

Amaç: Asetilsalisilik asite (ASA) yetersiz biyokimyasal yanıt 'ASA direnci' olarak tanımlanır. Yaygınlığı bilinmemektedir. Akut koroner sendrom (AKS) hastalarında ortalama trombosit hacmi (OTH) arttıkça mortalite ve kardiyovasküler olayların sıklığı artar. Yüksek OTH’li hastalar antiplatelet ajanlara daha dirençlidir. Çalışmamız AKS hastalarında ASA direnci ve trombosit reaktivitesinin zamansal değişkenliğini değerlendirmeyi ve OTH ile ilişkisini göstermeyi amaçlamıştır. Gereç ve Yöntemler: Çalışmamız tek merkezli prospektif, kesitsel bir çalışmadır. AKS nedeniyle hastaneye yatırılan ve perkütan koroner girişim uygulanan 18 yaş üstü hastalar çalışmaya dahil edildi. ASA direnci ve OTH ölçümleri başvuruda ve birinci ayda alındı. ASA direncinin yaygınlığı ve değişimi, OTH ile ilişkisi analiz edildi. Bulgular: Çalışmaya 115 hasta dâhil edildi. İlk başvuruda 7 hasta (%6,08) ASA dirençliydi ve 1. ay kontrolünde bu sayı 22'ye (%19,13) yükseldi (p=0,003). 1. ay kontrollerinde ASA direncindeki sayısal artış anlamlı bulundu (p<0,01). ASA direnci prevalansı %22,6 olarak hesaplandı. Başvuru anında MPV 16 hastada (%13,9) yüksek bulunurken, 1. ay kontrolünde 15 hastada (%13,04) yüksek bulundu (p=0,98). ASA direnci olan ve olmayan hastalarda MPV değerlerinin benzer olduğu görüldü. Sonuç: ASA direnci düşünüldüğünden daha yaygındır. Bu nedenle, trombosit işlevlerini değerlendirmek hastaların klinik sonuçlarını tahmin etmede, kullanılan antiplatelet ajanın etkinliğini belirlemede önemlidir.

Anahtar Kelimeler

• Akut koroner sendrom
• asetilsalisilik asit
• ortalama platelet hacmi

Kaynakça

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