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Journal: Journal of the Grodno State Medical University (Vol.20, No. 2)

Publication Date:

Authors : ; ; ;

Page : 152-158

Keywords : non-Q myocardial infarction; platelet aggregation; acetylsalicylic acid; clopidogrel; resistance;

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The aim of the study was to evaluate the incidence of high residual platelet reactivity (HRPR) in patients with non-Q myocardial infarction (non-Q-MI), depending on age and characteristics of therapy at different periods after the onset of MI. Methods. The study included 78 patients with acute non-Q-MI, who were divided into 3 subgroups (SG) depending on their age: SG1 (31-44 years) – 5 persons (6.4%), SG2 (45-59 years) – 36 individuals (46.2%), SG3 (60-74 years) – 37 individuals (47.4%). 34 people (43.6%) were treated conservatively, 44 people (56.4%) underwent primary percutaneous coronary intervention (PCI). Platelet aggregation was assessed using a Multiplate impedance aggregometer (Germany) with several aggregation inducers on admission, 12-14 days and 28-30 days after the onset of MI. Results. The analysis of aggregatograms in patients with non-Q-MI revealed the following indicators: 1ASPI-test 17.0 [10.0; 25.5] U, 2ASPI-test 25.0 [17.0; 36.0] U, 3ASPI-test 21.0 [15.0; 26.5] U (Friedman's test 22.2; p=0.00002); 1ADP-test 27.0 [19.0; 43.5] U, 2ADP-test 32.0 [22.0; 47.5] U, 3ADP-test 28.0 [19.0; 49.0] U (Friedman's test 4.9; р=0.09); 1TRAP-test 72.0 [59.5; 93.0] U, 2TRAP-test 88.0 [72.5; 111.0] U, 3TRAP-test 90.0 [71.5; 102.0] U (Friedman's test 19.7; р=0.00005). HRPR, indicating an insufficient response to antiplatelet therapy, was detected initially in 14 patients (17.9%) according to the ASPI-test, in 13 patients (16.6%) according to the ADP-test, in 5 patients (6.4%) according to the ASPI-test + ADP-test. On re-examination HRPR was revealed in 28 patients (35.9%) according to the ASPI-test (p<0.05), in 15 patients (19.2%) according to the ADP-test, in 9 patients (11.5%) according to the ASPI-test + ADP-test. On the third examination HRPR was detected in 15 patients (19.2%) according to the ASPI-test (p<0.05), in 17 patients (21.7%) according to ADP-test, in 10 patients (12.8%) according to the ASPI-test+ADP-test. The dynamics of changes of the aggregatogram and HRPR in age subgroups and in subgroups with different therapy was of a similar nature. Conclusion. A high percentage of patients with non-Q-MI associated with insufficient response to acetylsalicylic acid and clopidogrel was revealed at different times after the onset of MI. There were no differences in the aggregation parameters depending on the age of the patients, the type of therapy (conservative or PCI) or the type of implanted stents.

Last modified: 2022-05-26 22:04:18