Interv Akut Kardiol. 2006;5(6):256-258

RESISTANCE TO ANTIPLATELET THERAPY IN CLINICAL CARDIOLOGY

MUDr. Hana Ševčíková¹, prof. MUDr. Jan Vojáček DrSc¹, Radek Pudil¹, prof. MUDr. Jaroslav Malý CSc¹, Miroslav Pecka¹, Ilona Fátorová²

¹ I. interní klinika Fakultní nemocnice v Hradci Králové

² II. interní klinika, odd. klinické hematologie FN Hradec Králové

Antiplatelet therapy plays very important role in the treatment of ischaemic heart disease and its secondary prevention. Resistance to antiplatelet therapy ranks among the recent pathophysiological units that may have a fundamental influence on the therapy of patients treated with various drugs affecting platelet functions (acetylsalicylic acid or clopidogrel). We can define resistance to antiplatelet drugs clinically (manifestation of coronary events despite antiplatelet therapy) or laboratory (no inhibition of platelet aggregation in vitro). Etiology of resistance to antiplatelet therapy is complex. The causes of resistance can be divided into three groups (clinical, laboratory and genetic). The percentage of ASA non-responders represented in the population fluctuates from 5 to 45 % depending on the method used. Monitoring the effectivity of antiplatelet drugs can be divided into 2 groups (in vivo and in vitro). One of the most commonly used methods is optic aggregometry with inductors of aggregation. PFA-100 and ULTEGRA system are semi-automatic, rapid and simple methods. The methods are unspecific and unsensitive. There remain many unanswered questions in the topic of antiplatelet therapy resistance.

Keywords: Key words: acetylsalicylic acid, ischaemic heart disease, clopidogrel, ASA resistance, aggregometry.

Published: February 1, 2007  Show citation