Features of Clinical Course of Ischemic Heart Disease and Prognosis for Patients after Coronary Artery Stenting
Objective — to study the correlation between platelet aggregation parameters in patients after coronary artery stenting, clinical and anamnestic characteristics and drug therapy.
Materials and Methods. Our study included 75 patients with ischemic heart disease: 65 men (86.67 %) and 10 women (13.33 %) with a mean age of 58.0 ± 9.5 years and 59.5 ± 6.0 years, respectively. All patients underwent coronary artery stenting in the period from 2010 to 2012. All patients underwent coronary artery stenting in the period from 2010 to 2012. The complex examination of patients included physical, clinical and instrumental methods of examination (electrocardiography, Holter monitoring, bicycle ergometry, echocardioscopy). Study of platelet aggregation was carried out on a spectrophotometer SF-18 (Leningrad, Russia).
Results and Discussion. The data indicate that 77.3 % of patients were on dual antiplatelet therapy, and 20 % of patients were taking only one antiplatelet drug — acetylsalicylic acid. Patients weren’t significantly different from each other by aggregatogram indices, except «presence of disaggregation» index (100 % vs 80 %, p = 0.019). In patients after coronary artery stenting who had a negative test result in exercise tolerance test, the degree of platelet aggregation was significantly lower than in patients with a positive result of bicycle ergometry.
Conclusions. Dual antiplatelet therapy in patients with ischemic heart disease after coronary artery stenting provides more significant effect on indices of platelet aggregation. Unfavorable course of the disease is associated with inadequate reduction of platelet aggregation level and the lack of disaggregation.
Full Text:PDF (Русский)
Грацианский Н.А. Антитромбоцитарная терапия при коронарной болезни сердца. Некоторые проблемы и достижения // Атеротромбоз. — 2010. — Вып. 1. (4).
Ferreira-González I., Marsal J.R. et al. Double Antiplatelet Therapy After Drug-Eluting Stent Implantation: Risk Associated With Discontinuation Within the First Year // JACC. — Оctober 2012. — Vol. 60, issue 15.
Sakamoto Nobuo, Kazuhiko Nakazato et al. Very late stent thrombosis and neointimal plaque rupture after implantation of sirolimus-eluting stents: observations with angiography, IVUS and OCT // Cardiovascular Intervention and Therapeutics. — 2011. — Vol. 26, issue 3. — Р. 263-268.
Squizzato Alessandro, Tymen Keller, Erica Romualdi, Saskia Middeldorp. Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease // The Cochrane library. Cochrane Database Syst. Rev. — 2011 Jan. — № 19(1).
Steinhubl S.R. et al. Genotyping, Clopidogrel Metabolism, and the Search for the Therapeutic Window of Thienopyridines // Circulation. — 2010. — 121. — 481-483.
Tantry U.S., Gurbel P.A. Antiplatelet Drug Resistance and Variability in Response: The Role of Antiplatelet Therapy Monitoring // Curr. Pharm. Des. — 2012, Dec 26.
William Wijns et al. Guidelines on myocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) // European Heart Journal. — 2010. — 31. — Р. 2501-2555.
Copyright (c) 2017 EMERGENCY MEDICINE
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018