Evaluation of aspirin and clopidogrel resistance in patients with acute coronary syndrome by using adenosine diposphate test and aspirin test

O. Ibrahim, Oteh Maskon, Syukur A. A, Hamat Hamdi Che Hassan, S. Fadilah W, Md. Mostafizur Rahman

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Abstract

Objectives: To evaluate Aspirin and Clopidogrel resistance/non-responders in patients with acute coronary syndrome (ACS) by using adenosine diposphate and aspirin tests. Methodology: In the study patients with ACS loaded with 300 mg of clopidogrel and 300 mg aspirin and patients on stable daily dose of 75 mg of clopidogrel (more than 3 days) underwent PCI. Response to clopidogrel and Aspirin was assessed by Adenosine Diphosphate (ADP) Test (20 μmol/L) and Aspirin Test (Acetyl Acid) (ASP) 20 μmol/L, respectively, using the Multiplate Platelet Function Analyzer (Dynabyte Medical, Munich, Germany). Results: Sixty four patients were included in this study out of which 57 were with ACS and 7 scheduled for percutaneous coronary intervention (PCI) electively. The proportion of Aspirin good responders and adequate responders were 76.56% and 18.75%, respectively while adequate response and good response to Clopidogrel accounted for 29.7 and 48.4%, respectively Hyperlipidaemia was only co-morbidity associated with higher AUC ADP value (p: 0.046). Hypertriglyceridaemia and serum calcium were weakly correlated with higher AUC ADP serum calcium r=0.08, triglyceride r=0.12. Patients admitted for scheduled PCI and on stable dose of 75mg clopidogrel exhibited lower AUC ADP value as compared to those admitted with acute coronary syndrome given loading dose of 300mg of Clopidogrel. Post loading dose measurement of anti-platelet therapy among ACS patients using the Multiplate Platelet Function Analyzer showed comparable results with other methods. Conclusions: As determined by Multiplate Platelet Function Analyzer, Aspirin resistance/non-responders in this study in acute coronary syndrome patients accounted for 4.69% while Non-responders in Clopidogrel was 21.9%.

Original languageEnglish
JournalPakistan Journal of Medical Sciences
Volume29
Issue number1
Publication statusPublished - Jan 2013

Fingerprint

clopidogrel
Acute Coronary Syndrome
Adenosine
Aspirin
Adenosine Diphosphate
Percutaneous Coronary Intervention
Blood Platelets
Area Under Curve
Calcium
Hypertriglyceridemia
Hyperlipidemias
Serum

Keywords

  • Acute coronary syndromes
  • Anti-platelet therapy
  • Aspirin
  • Clopidogrel
  • Hyperlipidaemia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{c66badef430e4575b809eea2762e8ac0,
title = "Evaluation of aspirin and clopidogrel resistance in patients with acute coronary syndrome by using adenosine diposphate test and aspirin test",
abstract = "Objectives: To evaluate Aspirin and Clopidogrel resistance/non-responders in patients with acute coronary syndrome (ACS) by using adenosine diposphate and aspirin tests. Methodology: In the study patients with ACS loaded with 300 mg of clopidogrel and 300 mg aspirin and patients on stable daily dose of 75 mg of clopidogrel (more than 3 days) underwent PCI. Response to clopidogrel and Aspirin was assessed by Adenosine Diphosphate (ADP) Test (20 μmol/L) and Aspirin Test (Acetyl Acid) (ASP) 20 μmol/L, respectively, using the Multiplate Platelet Function Analyzer (Dynabyte Medical, Munich, Germany). Results: Sixty four patients were included in this study out of which 57 were with ACS and 7 scheduled for percutaneous coronary intervention (PCI) electively. The proportion of Aspirin good responders and adequate responders were 76.56{\%} and 18.75{\%}, respectively while adequate response and good response to Clopidogrel accounted for 29.7 and 48.4{\%}, respectively Hyperlipidaemia was only co-morbidity associated with higher AUC ADP value (p: 0.046). Hypertriglyceridaemia and serum calcium were weakly correlated with higher AUC ADP serum calcium r=0.08, triglyceride r=0.12. Patients admitted for scheduled PCI and on stable dose of 75mg clopidogrel exhibited lower AUC ADP value as compared to those admitted with acute coronary syndrome given loading dose of 300mg of Clopidogrel. Post loading dose measurement of anti-platelet therapy among ACS patients using the Multiplate Platelet Function Analyzer showed comparable results with other methods. Conclusions: As determined by Multiplate Platelet Function Analyzer, Aspirin resistance/non-responders in this study in acute coronary syndrome patients accounted for 4.69{\%} while Non-responders in Clopidogrel was 21.9{\%}.",
keywords = "Acute coronary syndromes, Anti-platelet therapy, Aspirin, Clopidogrel, Hyperlipidaemia",
author = "O. Ibrahim and Oteh Maskon and A, {Syukur A.} and {Che Hassan}, {Hamat Hamdi} and {Fadilah W}, S. and Rahman, {Md. Mostafizur}",
year = "2013",
month = "1",
language = "English",
volume = "29",
journal = "Pakistan Journal of Medical Sciences",
issn = "1682-024X",
publisher = "Professional Medical Publications",
number = "1",

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TY - JOUR

T1 - Evaluation of aspirin and clopidogrel resistance in patients with acute coronary syndrome by using adenosine diposphate test and aspirin test

AU - Ibrahim, O.

AU - Maskon, Oteh

AU - A, Syukur A.

AU - Che Hassan, Hamat Hamdi

AU - Fadilah W, S.

AU - Rahman, Md. Mostafizur

PY - 2013/1

Y1 - 2013/1

N2 - Objectives: To evaluate Aspirin and Clopidogrel resistance/non-responders in patients with acute coronary syndrome (ACS) by using adenosine diposphate and aspirin tests. Methodology: In the study patients with ACS loaded with 300 mg of clopidogrel and 300 mg aspirin and patients on stable daily dose of 75 mg of clopidogrel (more than 3 days) underwent PCI. Response to clopidogrel and Aspirin was assessed by Adenosine Diphosphate (ADP) Test (20 μmol/L) and Aspirin Test (Acetyl Acid) (ASP) 20 μmol/L, respectively, using the Multiplate Platelet Function Analyzer (Dynabyte Medical, Munich, Germany). Results: Sixty four patients were included in this study out of which 57 were with ACS and 7 scheduled for percutaneous coronary intervention (PCI) electively. The proportion of Aspirin good responders and adequate responders were 76.56% and 18.75%, respectively while adequate response and good response to Clopidogrel accounted for 29.7 and 48.4%, respectively Hyperlipidaemia was only co-morbidity associated with higher AUC ADP value (p: 0.046). Hypertriglyceridaemia and serum calcium were weakly correlated with higher AUC ADP serum calcium r=0.08, triglyceride r=0.12. Patients admitted for scheduled PCI and on stable dose of 75mg clopidogrel exhibited lower AUC ADP value as compared to those admitted with acute coronary syndrome given loading dose of 300mg of Clopidogrel. Post loading dose measurement of anti-platelet therapy among ACS patients using the Multiplate Platelet Function Analyzer showed comparable results with other methods. Conclusions: As determined by Multiplate Platelet Function Analyzer, Aspirin resistance/non-responders in this study in acute coronary syndrome patients accounted for 4.69% while Non-responders in Clopidogrel was 21.9%.

AB - Objectives: To evaluate Aspirin and Clopidogrel resistance/non-responders in patients with acute coronary syndrome (ACS) by using adenosine diposphate and aspirin tests. Methodology: In the study patients with ACS loaded with 300 mg of clopidogrel and 300 mg aspirin and patients on stable daily dose of 75 mg of clopidogrel (more than 3 days) underwent PCI. Response to clopidogrel and Aspirin was assessed by Adenosine Diphosphate (ADP) Test (20 μmol/L) and Aspirin Test (Acetyl Acid) (ASP) 20 μmol/L, respectively, using the Multiplate Platelet Function Analyzer (Dynabyte Medical, Munich, Germany). Results: Sixty four patients were included in this study out of which 57 were with ACS and 7 scheduled for percutaneous coronary intervention (PCI) electively. The proportion of Aspirin good responders and adequate responders were 76.56% and 18.75%, respectively while adequate response and good response to Clopidogrel accounted for 29.7 and 48.4%, respectively Hyperlipidaemia was only co-morbidity associated with higher AUC ADP value (p: 0.046). Hypertriglyceridaemia and serum calcium were weakly correlated with higher AUC ADP serum calcium r=0.08, triglyceride r=0.12. Patients admitted for scheduled PCI and on stable dose of 75mg clopidogrel exhibited lower AUC ADP value as compared to those admitted with acute coronary syndrome given loading dose of 300mg of Clopidogrel. Post loading dose measurement of anti-platelet therapy among ACS patients using the Multiplate Platelet Function Analyzer showed comparable results with other methods. Conclusions: As determined by Multiplate Platelet Function Analyzer, Aspirin resistance/non-responders in this study in acute coronary syndrome patients accounted for 4.69% while Non-responders in Clopidogrel was 21.9%.

KW - Acute coronary syndromes

KW - Anti-platelet therapy

KW - Aspirin

KW - Clopidogrel

KW - Hyperlipidaemia

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M3 - Article

VL - 29

JO - Pakistan Journal of Medical Sciences

JF - Pakistan Journal of Medical Sciences

SN - 1682-024X

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