Multiple Electrodes Aggregometry - a New Method to Assess the Platelet Reactivity in Non-st Elevation Acute Coronary Syndrome Patients

Abstract

REZUMAT MULTIPLE ELECTRODES AGGREGOMETRY A NEW METHOD TO ASSESS THE PLATELET REACTIVITY IN NON-ST ELEVATION ACUTE CORONARY SYNDROME PATIENTS Daniela Maximov1, Adina Ionac2, Alina Lupu1, Cristian Mornos2, Stefan I. Dragulescu2 Introduction: Non-ST segment elevation acute coronary syndrome (NSTE ACS) patients are at high risk for development of new cardiovascular (CV) ischemic events. Determination of lowor non-responder status to dual antiplatelet therapy in patients undergoing coronary stenting for NSTE ACS may be a useful method to detect the highrisk patients of this category. Material and methods: We prospectively studied the platelet response to clopidogrel and aspirin in 100 patients admitted in Timisoara Institute of Cardiovascular Diseases undergoing percutaneous coronary intervention (PCI) with stenting for NSTE ACS. A sample of whole blood was obtained before PCI and analyzed by multiple electrodes aggregometry (MEA), using ADP and arachidonic acid (AA) agonists to detect the non-responder status to clopidogrel and aspirin. We used MEA performed with Multiplate (Dynabyte, Germany) to assess the posttreatment platelet reactivity. Patients were stratified into quartiles according to the ADP-induced platelet aggregation. Patients of the highest quartile (Q 4) were defined as the “low-responders”. Results: Ten recurrent CV events occurred during the 1-month follow-up. Clinical CV events were significantly associated with platelet response to clopidogrel [Q4 vs. 1, 2, 3: OR (95% CI) 19.8 (4.4-90.8; P<0.001)]. Conclusions: The MEA assessment of ADP and AAinduced platelet aggregation is a valuable method to identify the low-responders to dual antiplatelet therapy. The results correlated the values of the area under curve (AUC) determined by MEA with the clopidogrel low-responder status and with an increased risk of recurrent CV ischemic events 1-month follow-up post PCI + stent in NSTE ACS patients.

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Cite this paper

@inproceedings{Maximov2012MultipleEA, title={Multiple Electrodes Aggregometry - a New Method to Assess the Platelet Reactivity in Non-st Elevation Acute Coronary Syndrome Patients}, author={Daniela Maximov and Adina Ionac and Alina Lupu and Cristian Mornoș and Stefan Iosif Drăgulescu}, year={2012} }