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Determination of the Prevalence of Aspirin and Clopidogrel Resistances in Patients with Coronary Artery Disease by using Various Platelet-function Tests / 대한진단검사의학회지
Article em En | WPRIM | ID: wpr-120820
Biblioteca responsável: WPRO
ABSTRACT
BACKGROUND: Dual therapy with aspirin and clopidogrel has emerged as the gold standard therapy for patients treated with drug-eluting stents (DES). However, there is variability in patients' responses to this antiplatelet therapy, and some patients continue to show ischemic recurrences after therapy. The purpose of the study was to compare the simultaneously obtained results of various platelet-function tests for assessing the prevalence of antiplatelet resistance in coronary artery disease patients undergoing DES therapy. METHODS: A total of 66 patients were administered a loading dose of aspirin, clopidogrel, and cilostazol at least 12 hr before stenting. The results of VerifyNow (Accumetrics, USA), multiplate analyzer (Dynabyte Medical, Germany), and vasodilator-stimulated phosphoprotein/P2Y12 (Biocytex, France) assays were compared with those of light transmission aggregometry (LTA) analysis. RESULTS: The P2Y12 reaction units and P2Y12% inhibition values obtained using the VerifyNow assay showed strong correlation (r) with the results of the LTA analysis. All tests results showed low concordance in defining the antiplatelet resistance in patients, and the degrees of agreement were as follows: 0 for aspirin reaction units; 0.25, P2Y12% inhibition; 0, aspirin-sensitive patients' identification test; 0.21, ADPtest; and 0.14, platelet reactivity index, expressed as the kappa statistics. The prevalence of aspirin and clopidogrel resistances in patients resulted in remarkable variations, from 0% to 22.7% and from 9.1% to 48.5%, respectively. CONCLUSIONS: The clinical usefulness of the different assays for the correct classification of patients in terms of antiplatelet resistance remains unclear. Further studies are required to determine the best method for correlating the occurrences of adverse ischemic events.
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Texto completo: 1 Índice: WPRIM Assunto principal: Testes de Função Plaquetária / Tetrazóis / Doença da Artéria Coronariana / Ticlopidina / Resistência a Medicamentos / Inibidores da Agregação Plaquetária / Agregação Plaquetária / Aspirina / Quimioterapia Combinada / Stents Farmacológicos Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: The Korean Journal of Laboratory Medicine Ano de publicação: 2010 Tipo de documento: Article
Texto completo: 1 Índice: WPRIM Assunto principal: Testes de Função Plaquetária / Tetrazóis / Doença da Artéria Coronariana / Ticlopidina / Resistência a Medicamentos / Inibidores da Agregação Plaquetária / Agregação Plaquetária / Aspirina / Quimioterapia Combinada / Stents Farmacológicos Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: The Korean Journal of Laboratory Medicine Ano de publicação: 2010 Tipo de documento: Article