Korelacija biohemijskih i antropometrijskih parametara sa odgovorom na klopidogrel kod bolesnika lecenih perkutanim koronarnim intervencijama

Abstract

Introduction: Clopidogrel in combination with acetylsalicylic acid in our conditions is standard double antiplatelet therapy for prevention of thrombosis after revascularization with percutaneous coronary intervention. Significantly higher percentage of patients has low response to clopidogrel because of clinical, cytological and genetic factors. The aim: The aim of the study was to establish correlation between response to clopidogrel in patients treated with percutaneous coronary interventions and anthropometric and biochemical characteristics of patients, risk factors and comorbid diseases. Material and Methods: Study was performed on a group of 68 patients with coronary disease, consisting of blood test, biochemical analysis and impedance multiplate agregometry. As statistical methods, we used Student's T - test, Chi - square test and Spearman's rank correlation coefficient. Results: Statistically significant lower response to clopidogrel was found in the group of patients who have higher values of fibrinogen and platelet count (p < 0.05). There is no correlation found between response to clopidogrel and next parameters - ages, sex, BMI, kidney dysfunction, MPV, PDW, diabetes mellitus and smoking. Conclusion: Patients who were treated with percutaneous coronary interventions and have higher platelets count and higher concentration of fibrinogen should be reevaluated and instead of standard doses of clopidogrel consider using double doses of clopidogrel or new, more potent antiplatelet ADP blockers, like ticagrelor and prasugrel.