ISPARTA VE ÇEVRESİNDE KLOPİDOGREL DİRENCİNİN ARAŞTIRILMASI.

Objective Clopidogrel therapy is the standard of care in patients with acute coronary syndrome (ACS) and stent implantation. However, Clopidogrel resistance (CR) is arising increasingly and was associated with increased adverse outcomes. Therefore, detection of these subjects in daily practice is important in order to switch to more aggressive therapy and closer follow up. The platelet function tests for measurement aspirin and clopidogrel resistance are very expensive and time consuming. We need have practically, easily accessible, cheaper and reliable parameters for detecting CR. Material and Methods A total of 541 patients who had been on clopidogrel and aspirin therapy for the diagnosis of acute coronary syndrome were enrolled in this study. CR was analyzed by Multiplate MP-0120 device by using the method of whole blood aggregometry. The amount of ADP induced platelet aggregation was assessed as area under curve (AUC), and a cut off value of 470 for clopidogrel resistance above which the patient is considered as clopidogrel resistance, was used. Results Clopidogrel resistance was found in 65 patients, among the 541 patients analyzed. Among the 541 patients analyzed 65 were found to be CR (% 12.2). CR was more common in female sex, diabetes mellitus and hyperlipidemia history (p=0.005, p=0.016, p< 0.001). However, CR was reduced by smoking (p= 0.046). In patients with CR, calcium and platelet levels were higher than patients with normal clopidogrel response. Conclusion This study showed that hyperlipidemia, platelet count, body mass ındex and female gender are associated with CR. [ABSTRACT FROM AUTHOR]