Shutdown reactivity of platelets to adenosine diphosphate anr arachidoic acid and its prognostic value in patients with myocardial infraction with elevation of ST segment
Keywords:antipleteled therapy, myocardial infraction, prognosis, reactivity of platelets, ADP, arachidoic acid
The double antiplateled therapy (DAT) with an acetylsalicylic acid (ASA) and clopidogrel is a standard therapy of patients with myocardial infraction but its efficiency in patients is different. Cardiologists of all over the world chose the causes of aforesaid for a long time.
Aim of research is to establish predictors of development of a high shutdown reactivity of platelets (HSTR) to ADP and AA (arachidoic acid) in patients with MFST (myocardial infraction with elevation of ST segment) and to evaluate its impact on the clinical course.
Materials and methods: It was examined 105 patients with an acute coronary syndrome with elevation of ST segment who underwent thrombolytic therapy. Examination of SRP (shutdown reactivity of platelets) to ADP and AA was carried out on analyzer of aggregation ALAT-2
Results: Values of SRP to AA >1,33 relative units (RU) an odds ratio (OR) 4.6; 95% of confidence interval (CI) 3.3-15.4, р<0,001) and for ADP >1,78 RU (OR 5.4; 95%CI 4.7-13.3, р<0,001) were considered high.
Survivability in patients with level SRP to AA >1,33 and to ADP >1,78 ВО was reliably lower than in patients with level <1,33 RU (р=0,042) і <1,78 RU (р=0,034), respectively. Multifactorial regressive analysis revealed an independent predictors of an increase of SRP to AA and ADP, among them the levels of estradiol, progesterone and its ratio in postmenopause (PM), duration of an arterial hypertension (AH) and postmenopause, pancreatic diabetes (PD)of the 2 type and female sex (all p<0,05).Conclusions. In patients with MI an increase of SRP to AA and ADP is associated with a growth of risk of CEP development in 4,6 і 5,4 times
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