Hemostasiological Aspects of PCI: Periprocedural Changes in the Activity of the Platelet Link of Hemocoagulation on the Background of Prior Double Antiplatelet Therapy in Patients with Chronic Coronary Syndrome

Abstract

The aim. To analyze changes in the activity of the platelet link of hemocoagulation in patients with chronic coronary syndrome before and after percutaneous coronary intervention (PCI) against the background of prior antiplatelet therapy. Materials and methods. We examined 67 patients (mean age 65.2±8.6 years) who were undergoing inpatient treatment at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. Patients with different regimens of antiplatelet therapy were compared before and after PCI. At the time of hospitalization, patients were receiving both monotherapy and dual antiplatelet therapy (those with a history of myocardial infarction up to 12 months) in standard doses. The control group consisted of 25 people of similar age (62.7±6.5 years). The activity of platelet hemostasis was evaluated by the turbidimetric method and the light transmission fluctuation method. Statistical processing was carried out using the MedStat v.5.2 and Statistica 8.0 software. Results. Before PCI, dual antiplatelet therapy using aspirin and ticagrelor suppressed the activity of platelet hemostasis, compared to dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Patients receiving monotherapy did not achieve the desired effect. After PCI, the group of patients who took the combination of aspirin and ticagrelor responded better to the therapy than those who received aspirin and clopidogrel. Conclusions. The use of dual antiplatelet therapy with acetylsalicylic acid and ticagrelor reduced both spontaneous and induced aggregation.

Keywords

• platelet hemostasis
• coronary artery disease
• antithrombotic therapy
• p2y12 receptors
• coronary artery stenting