FEATURES OF PLATELET HEMOSTASIS IN PATIENTS WITH VARIOUS SENSITIVITY TO ANTIPLATELET THERAPY IN STABLE ANGINA PECTORIS AFTER PLANNED PERCUTANEOUS CORONARY INTERVENTION

Abstract

Background. One of the significant problems of using double antiplatelet therapy (DATT) in patients with ischemic heart disease is the development of resistance to acetylsalicylic acid (ASA) and to clopidogrel. Purpose of the study. Evaluation of the features of platelet hemostasis in patients with different sensitivity to DATT with stable angina pectoris (SAP) who have undergone scheduled percutaneous coronary intervention (PCI). Material and methods. Sixty patients with stable angina pectoris who underwent planned PCI and received DATT were examined. A blood test and a study of the morphometric parameters of platelets: MPV, PDW, PCT, P-LCR were performed by means of cytoflowing method on the automatic hemo-analyzer Sysmex XS-500i, Japan. Platelet aggregation was evaluated on an impedance 5-channel Multiplateaggregometer (VerumDiagnostica GmbH, Germany) with several aggregation inducers. Results. 45% of patients with insufficient response to DAPT were detected – SG2. TRAP-test was 90.62 ± 18.37 U in SG1, 110.7 ± 19.83 U in SG2, p <0.05; MPV was 8.87 ± 1.71 fl in SG1, 9.85 ± 1.42 fl in SG2, p <0.05; P-LCR was 29.74 ± 5.38% in SG1, 33.96 ± 5.70% in SG2, p <0.05. Conclusions. In 45% of patients with SAP, there is an inadequate response to DATT, of which 18 patients (30%) to ASA, 15 people to clopidogrel (25%), to two drugs at the same time - 6 people (10%). In patients with an inadequate response to DATT, MPV and P-LCR are significantly higher than those with normal response to DATT. Correlation analysis revealed interrelations between the MPV, PCT, PLC-R indices and aggregation values, which confirm the idea that one of the factors reducing the effectiveness of DATT is the initially high platelet activity and their high heterogeneity in size.

Keywords

• impedance aggregometry
• plateletes
• acetylsalicylic acid
• clopidogrel