Application of cationic propyl gallate as inducer of thrombocyte aggregation for evaluation of effectiveness of antiaggregation therapy.

INTRODUCTION AND AIM OF THE STUDY: Acetylsalicylic acid (ASA) is one of basic preparations used in the therapy of cardiovascular diseases. Application of ASA leads to irreversible reduction of platelet aggregation. The aim of the present study was to verify monitoring of effectiveness of ASA therapy using the measurement of platelet aggregability in vitro after induction by cationic propyl gallate (CPG), which is considered to be a highly potent inducer of aggregation. METHODS: We examined a group of 27 healthy volunteers, divided into two subgroups (n = 19, n = 8). The first subgroup was examined for thrombocyte aggregation before and 24 hours after administration of 400 mg of ASA after induction by ADP, collagen, adrenalin and CPG. The second subgroup was examined for thrombocyte aggregation before and after a three-day administration of ASA in a dose of 100 mg/day. RESULTS AND CONCLUSION: In the group of 27 healthy volunteers we determined normal values of aggregability for individual inducers. Low stability of the used methods was proved (weak or insignificant correlation of results of the same method before and after administration of ASA). The most advantageous parameter for monitoring of effectiveness of 400 and 100 mg of ASA was CPG slope (paired t test, p < 0.00000002, resp. p < 0.001). The parameter of CPG slope we determined in both subgroups the cut-off value (< 53s), by means of which it is possible to discriminate probands according to ASA therapy (in contrast to other routinely used inducers). The obtained results indicate that measurement of thrombocyte aggregation after CPG induction reveals a significantly lower percentage of ASA non-responders ASA than after other inducers. Measurement of thrombocyte aggregation after CPG induction is predicted to be highly promising for monitoring the effectiveness of anti-aggregation therapy.

[Initial experience with use of cationic propyl gallate as an inducer of thrombocyte aggregation in evaluation of anti-aggregation therapy]. / První zkusenosti s vyuzitím kationického propylgallátu jako induktoru agregace trombocytu v hodnocení úcinnosti antiagregacní terapie.

INTRODUCTION AND OBJECTIVE: Acetylsalicylic acid (ASA) is one of the basic preparations which are used in the treatment of cardiovascular diseases. ASA administration leads to irreversible restriction of platelet aggregation. The objective of our work was to test possibilities of monitoring the effectiveness of ASA therapy by measuring the platelet aggregability in vitro after induction with cationic propyl gallate (CPG) which is considered a very potent aggregation inductor. METHOD: We examined a group of 27 healthy volunteers divided into two sub-groups (n = 19, n = 8). In the first sub-group the platelet aggregation was examined before and after 24 hours following ingestion of 400 mg ASA after induction with ADP, collagen, adrenaline and CPG. In the second sub-group the platelet aggregation was examined before and after three-day administration of ASA--100 mg/day. RESULTS AND CONCLUSION: In a group of 27 volunteers we assessed normal values of aggregation after different inductors. A low stability of the methods used was proved (low stability or insignificant correlation of results of the same method before and after ASA ingestion. The most useful parameter by means of which it was possible to monitor the effectiveness of administration of 400 or 100 mg ASA was the C/G slope (paired t-test, p < 0.0000002, and p < 0.001 resp.). In parameter CPG slope we were able to assess in both groups the cut-off value (< 53%/min.) by means of which it is possible to discriminate probands according to ASA therapy (contrary to the other commonly used inductors). From the results ensues that when assessing the thrombocyte aggregation after CPG induction we find a significantly lower percentage of so-called ASA non-respondents than after other inductors. We consider the use of assessment of thrombocyte aggregation after CPG induction when monitoring antiaggregation therapy a very promising procedure.