Pranas Šerpytis, Audronė Milčiūtė, Neringa Karvelytė, Rokas Navickas, Maksim Dmitrijev
Abstract
The Aim of the Research: 1. This study aims to compare how residual platelet reactivity is related with coronarographic findings in acute coronary syndrome(ACS) cases following a PCI. 2. Investigate if medication used before PCI has any prediction value in clopidogrel resistance. 3. Adittionally to investigate if laboratory findings has any prediction value in clopidogrel resistance within our cohort. Methodology: Thirty four patients admitted to the Vilnius University Hospital Santariskiu clinics intensive cardiac care unit with a diagnosis of ACS who had COG and PCI performed as part of the treatment were enrolled into the study. They were followed up for 30 days after the PCI, divided into groups with or without acute stent thrombosis (only the ones, who developped new ACS symptoms had a repeat COG). On-treatment platelet reactivity was measured, it was quantified using VerifyNow P2Y12 assay (PRU< 193 thrombocyte dysfunction,PRU>=193 – <230 low risk, PRU>=230 high risk of thrombosis due to clopidogrel resistance). All patients received clopidogrel loading dose of 300mg at the time of the PCI followed by a 75mg daily maintenance dose. Platelet reactivity was measured more than 24h after the initiation of clopidogrel. The Results of the Research: Mean age of the whole cohort was 62,94±12,5. 29 (85,3%) patients were male, 22 patients (64.7%) reported result was in 18 (52,9%) cases. INH < 40% was in 27 (79,4%) cases. Group with the in-stent restenosis, showed a correlation between increasing pre-PCI/COG WCC and increasing PRU values with decreasing INH% value (p<0.05). Conclusion: 1. Residual platelet reactivity is directly related with coronarographic findings in acute coronary syndrome cases following a PCI. 2. Some of medications used before PCI has prediction value in clopidogrel resistance. 3. A clinically significant correlation between WCC and PRU as well as INH value was demonstrated. 4. Opening a new page for future investigations and data research while searching for external or internal factors influencing the clopidogrel resistance.
Articel in Lithuanian
doi:10.5200/sm-hs.2012.103
Keyword(s): residual platelet reactivity; clopidogrel resistance; stent thrombosis; in-stent restenosis; VerifyNow P2Y12 assay
DOI: 10.5200/348
Full Text: PDF