Abstract
Coronary angioplasty is an important component of coronary heart disease (CHD) management. There is a substantial evidence of the need for dual antiaggregant therapy (clopidogrel and aspirin) in this clinical group, both before and after the intervention. The development of thrombotic complications during antiaggregant therapy suggests the antiplatelet drug resistance. The prevalence of this condition varies from 5% to 45% for aspirin, and from 20% to 45% for clopidogrel, depending on the assessment method and the specific clinical group. For dual antiplatelet therapy, the resistance prevalence is 6-8%. Presently, the gold standard method of the platelet functional activity assessment is optical aggregometry. To assess the resistance to aspirin, arachidonic acid is used as an aggregation inductor, with the calculation of absolute aggregation levels. To assess the resistance to clopidogrel, ADP is used as an aggregation inductor, and the relative aggregation parameters are calculated. The development of aspirin resistance is influenced by biological, clinical, and genetic factors. The clopidogrel resistance is associated with certain medications, hyperglycemia, atherosclerosis, and CYP2C19*2 gene polymorphism. Identification of the patients resistant to antiplatelet drugs enables the clinicians to adjust the antiplatelet treatment reasonably early and to reduce the risk of cardiovascular events. The possible methods of overcoming antiplatelet drug resistance are to double the loading and maintenance doses of clopidogrel and to use new agents.
Highlights
Coronary angioplasty is an important component of coronary heart disease (CHD) management
There is a substantial evidence of the need for dual antiaggregant therapy in this clinical group, both before and after the intervention
The development of thrombotic complications during antiaggregant therapy suggests the antiplatelet drug resistance. The prevalence of this condition varies from 5% to 45% for aspirin, and from 20% to 45% for clopidogrel, depending on the assessment method and the specific clinical group
Summary
В исследовании CREDO (Clopidogrel for the Reduction of Events During Observation) показано преимущество двойной АТТ аспирином 325 мг и клопидогрелом 75 мг после нагрузочной дозы клопидогрела 300 мг при лечении больных, подвергнутых ЧКВ. Понятие резистентности к АТП Считается, что недостаточная эффективность АТТ (относительно высокая частота неблагоприятных событий, для предотвращения которых она осуществляется) обусловлена не только тяжестью основного процесса (атеросклероза) и исходными изменениями функции тромбоцитов, но и широкой вариабельностью чувствительности тромбоцитов к входящим в двойную комбинацию средствам (АСК и клопидогрелу).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
