THE STATE OF RESISTANCE TO ANTIPLATELET THERAPY IN PATIENTS WITH CORONARY HEART DISEASE IN THE STUDY OF PLATELET AGGREGATION

Abstract

Studies in recent years have confirmed that the occurrence of violations in the system of thromboembolism in the pathogenesis of ischemic heart disease and resistance to aspirin almost double the risk of ischemic events. This entails the development of modern approaches aimed at controlling the treatment of ischemic heart disease, the appointment of a timely harmonic antiaggregant treatment plan. The aim of the study is to evaluate the functional status of thrombocytes in patients with stable tension stenocardia (STS) II-III functional class of heart ischemic disease who received acetylsalicylic acid (ASA) for short and long periods. Material and methods. As a source of research, 116 patients treated with a diagnosis of stable tension stenocardia II–III functional class were selected. Patients were divided into four groups according to the duration of admission of acetylsalicylic acid. Patients who received the 1st Group ASA for up to a year, patients who received the 2nd Group ASA for a period of 1 to 5 years, patients who received the 3rd Group ASA for more than 5 years, and patients who did not receive the control group ASA. Platelet aggregation testing was performed on a two – channel laser Alat-2 Biola Analyzer by means of computer processing using traditional turbidometric AGGR program on Born and O'brayen. Results. In the group of patients treated with aspirin for more than 5 years, the rates of spontaneous platelet aggregation and ADP-induced aggregation were higher than in the group of patients treated with ASA for 1 year and treated with ASA for 1 to 5 years, and statistically significant differences were observed compared with the indicators of the group of patients treated with ASA for up to 1 year (spontaneous aggregation of 1.7±0.09 p<0.05, 0.1 µm ADP-induced aggregation of 6.58±0.86 p<0.05, 1.0 ADP-induced aggregation of 16.51±1.63 p<0.01, 5.0 ADP-induced aggregation of 58.44±3.72 p<0.01). In the third group of patients treated with ASA for more than 5 years, resistance to aspirin was significantly more frequent than in the second group of patients treated with ASA for up to 5 years (54.8% and 29%, respectively, Chi2=4.24 r<0.05). And also, in the 1st group of patients treated with ASA before 1 year, the frequency of resistance was observed less than in patients treated with ASA for more than 5 years (13.3% and 54.8%, respectively, Chi2=11.63 r<0.05). Conclusions. In ischemic heart disease treated with aspirin for more than 5 years, an increase in platelet aggregation is associated with the risk of developing resistance to aspirin.