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ANTIPLATELET DRUGS RESISTANCE IN PATIENTS WITH ISCHEMIC HEART DISEASE AND OBLITERATIVE ATHEROSCLEROSIS OF LOWER LIMB ARTERIES ASSOCIATED WITH DIABETES MELLITUS TYPE 2

https://doi.org/10.20996/1819-6446-2009-5-3-51-54

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Abstract

Aim. To study a rate of resistance to acetylsalicylic acid (ASA) and clopidogrel and clinical outcomes in patients with atherosclerosis and diabetes mellitus type 2 (DM2).

Material and methods. 154 patients were involved in the study and split into two groups. 100 patients (47 men, 53 women; aged 66,4±7,8 y.o.) with ischemic heart disease (IHD) (which was presented by angina pectoris, class I-III, or myocardial infarction history) were included into the first group (G1). Other 54 patients (38 men, 16 women; aged 64,1±10,2 y.o.) with IHD associated with obliterative atherosclerosis of lower limb were included into the 2nd group (G2). Platelet aggregation was evaluated by Born's method (inducers of platelet aggregation were arachidonic acid and ADP). Reduction of platelet aggregation ≥20% after arachidonic acid induction was considered as criterion of resistance to ASA. Patients were considered as resistant, partly resistant and sensitive to clopidogrel if platelet aggregation reduced on <10%, 10-29%, and ≥30% respectively.

Results. Rate of ASA and clopidogrel resistance in patients with DM2 was significantly higher than these in patients without DM2 (48% vs 16% respectively, р=0,003 in G1; 42% vs 7% respectively, р=0,007 in G2).

Conclusion. Resistance to antiplatelet drugs is observed more often in patients with DM2 and can result in increased risk of cardiovascular complications.

About the Authors

E. V. Gorjacheva
Moscow Medical Academy named after I. M. Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


A. E. Udovichenko
Moscow Medical Academy named after I. M. Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


V. A. Sulimov
Moscow Medical Academy named after I. M. Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


N. V. Lavrishcheva
Moscow Medical Academy named after I. M. Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


M. A. Surikova
Moscow Medical Academy named after I. M. Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


T. N. Gracheva
Moscow Medical Academy named after I. M. Setchenov
Russian Federation
Bolshaya Pirogovskaya ul. 6, Moscow, 119991


References

1. Davies M.J., Bland J.M., Hangartner J.R. et al. Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischemic death. Eur Heart J 1989;10(3):203–8.

2. Falk E. Plaque rupture with severe pre–existing stenosis precipitating coronary thrombosis. Characteristics of coronary atherosclerotic plaques underlying fatal occlusive thrombi. Br Heart J 1983;50(2):127–34.

3. Fuster V., Fallon J.T., Badimon J.J., Nemerson Y. The unstable atherosclerotic plaque: clinical significance and therapeutic intervention. Thromb Hemost 1997;78(1):247–55.

4. Steinhubl S.R., Berger P.B., Mann J.T. 3rd et al. CREDO Investigators. Clopidogrel for the reduction of events during observation. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002;288(19):2411–20.

5. Gum P.A., Kottke-Marchant K., Welsh P.A. et al. A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease. J Am Coll Cardiol 2003;41(6):961–5.

6. Cattaneo M. Aspirin and clopidogrel: efficacy, safety, and the issue of drug resistance. Arterioscler Thromb Vasc Biol 2004;24(11):1980–7.

7. Krasopoulos G., Brister S.J. Beattie W.S., Buchanan M.R. Aspirin "resistance" and risk of cardiovascular morbidity: systematic review and meta-analysis. BMJ 2008;336(7637):195-8.


For citation:


Gorjacheva E.V., Udovichenko A.E., Sulimov V.A., Lavrishcheva N.V., Surikova M.A., Gracheva T.N. ANTIPLATELET DRUGS RESISTANCE IN PATIENTS WITH ISCHEMIC HEART DISEASE AND OBLITERATIVE ATHEROSCLEROSIS OF LOWER LIMB ARTERIES ASSOCIATED WITH DIABETES MELLITUS TYPE 2. Rational Pharmacotherapy in Cardiology. 2009;5(3):51-54. (In Russ.) https://doi.org/10.20996/1819-6446-2009-5-3-51-54

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)