RESUMEN
Objectives: Many patients undergoing antiplatelet therapy continue to experience thrombotic events and failure of therapy leading to so-called 'resistance' to antiplatelet therapy. Recently, there has been an increasing focus on in vitro laboratory monitoring of platelet functions, which has the promise of identifying these patients. This study aimed to document the prevalence of laboratory evidence of resistance to aspirin and clopidogrel therapy in Saudi patients with stable coronary heart disease [CHD]
Methods: Light transmission aggregometry in plateletrich plasma was performed in response to adenosine diphosphate [ADP], arachidonic acid [AA], collagen and adrenaline. In addition, a platelet function analyser [PFA100] was employed using both collagen/ADP and collagen/epinephrine cartridges
Results: Light transmission aggregometry [LTA] identi- fied the resistance to aspirin and clopidogrel therapy, according to the persistence of the aggregation response to AA aggregation, to be 13% and 26%, respectively. By PFA100 testing, closure times within the limits of laboratory reference values indicated residual platelet reactivity, and the prevalence of resistance to anti-platelet therapy was reported to be 33% for collagen/ADP cartridges and 30.7% for collagen/epinephrine. A concordance between LTA and PFA100 CT was noted in only 22.6% of patients
Conclusion: This study showed a wide prevalence of ontreatment platelet reactivity in patients with CHD on dual platelet therapy [aspirin and clopidogrel]. In addition, the global whole blood test of platelet function by PFA100 estimated a much higher prevalence of resistance than LTA when compared to the gold standard and more specific LTA analysis
RESUMEN
To study the relationship between -174 GC interleukin-6 single nucleotide polymorphism and hypertensive disorders of pregnancy [HDP] in Saudi women. In this case-control study, 109 HDP patients and 100 women with normal pregnancy as a control group were studied. The HDP study group constituted of 60 women with gestational hypertension [GH] and 49 women with preeclampsia [PE]. All women were randomly selected from the antenatal clinic and the prenatal and postnatal wards at the Antenatal Clinic and the Obstetric Ward of King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from April 2010 to December 2011. The -174 GC of IL-6 SNP was determined using real time polymerase chain reaction, allele discrimination technique. Distribution of -174 GC of IL-6 genotype in HDP patients was GG [58.5%], GC [31.1%], and CC [10.4%], while in the control group was GG [67%], GC [30.9%], and CC [2.1%]. The CC homozygosity was significantly associated with HDP [odds ratio [OR] = 5.76; 95% confidence interval [CI] 1.23 - 27.06, p=0.03]. This association only manifested with GH [OR = 7.65; 95% CI = 1.54-38.03, p=0.01]. However, no significant association was found with PE [OR = 3.48; 95% CI = 0.55-21.99, p=0.19]. The results indicate a positive association between -174 GC of IL-6 genotype and the risk of HDP. Genotypes CC and GC are associated with increased risk of GH but not with PE, suggesting that they are of differing genetic predisposition/pathophysiology
RESUMEN
To investigate the relationship between cluster of differentiation [CD]36 gene variant rs1761667 [G>A] and metabolic syndrome [MetS] and its components in Egyptian patients. This case-control study was conducted on MetS patients attending Suez Canal University Hospital, Egypt from November 2010 to October 2011. Peripheral blood was collected from 100 patients and 100 healthy controls for DNA extraction. The single nucleotide polymorphism [SNP] CD36 gene rs1761667 G>A was genotyped using realtime polymerase chain reaction, and the allele discrimination technique. Distribution of CD36 genotypes in the patient group was AA [n=25], AG [n=70], and GG [n=5], while in the control group it was AA [n=51], AG [n=48], and GG [n=1]. Both AG and GG genotypes were significantly more prevalent among MetS patients [p<0.001]. The odds ratio [OR] for the high risk allele [G] is 2 with 95% confidence interval from 1.30-3.07 [p<0.001]. Patients with genotypes AG and GG had significantly higher systolic blood pressure, wider waist circumstance, and higher degree of dyslipidemia [p<0.001] than patients with genotype AA. Our findings show that CD36 rs1761667 SNP is positively associated with increased risk of MetS and its components with genotype AG heterozygotes showing highest frequency among MetS patients.