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Rezistenca na klopidogrel in tveganje za nastanek subakutne tromboze v žilni opornici po perkutanem koronarnem posegu = Clopidogrel resistance and risk of subacute stent thrombosis after percutaneous coronary intervention
Starc, Radovan ; Starc, Saša
The dual antiplatelet treatment with aspirin and clopidogrel (CLO) decreases the rate of subacute stent thrombosis considerably. Despite the common practice of pretreatment with the high loading dose ...of CLO prior to coronary stenting (PCI), the time dependence as well as the efficacy of loading dose onplatelet aggregation inhibition (PI) are yet to be determined. The PI efficacy of 375 mg of CLO after 12 hours was determined by the determination of P-selectine by flow cytometry in our study. The results have disproved the hypothesis that the high loading, dose of CLO 375 mg with a pretreatment interval of 12 hours guarantees adequate PI. The results have confirmed the inter-individual variability of the CLO response hypothesis (nonrespoders, semi-responder).The individual P-selectine value analyses revealed in 7 out of16 patients (43.7 %) an inadequate PI response (non-responders, semi-responders) and up to 30% accrding to the literature. The weight and BMI adjustments have not brought about an improvement in PI. No side-effects have been reported as a result of a high, "off-labelled" loading dose of CLO. In conclusion, it is essential not to expose PTS to an inefficient drug, and identify those who could benefit from the alternative antiplatelet treatment.
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