Dysaggregants effect of platelet aggregation in patients with non-5T segment elevation acute coronary syndrome


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Aim. To study efficacy of treating patients with acute coronary syndrome (ACS) without ST segment
elevation (STSE) with platelet dysaggregation drugs (aspirin, cardiomagnil, clopidogrel).
Material and methods. 78 ACS without STSE were randomized into five groups: group 1 patients
(n = 17) received no dysaggregants; patients of group 2 (n = 26) received aspirin in the dose 250 mg
on the day of admission and then 125 mg/day; group 3 was given cardiomagnil (150 mg on the day of
admission and then 75 mg/day, n = 17); group 4 - clopidogrel 75 mg/day (n = 7); group 5 - combination of clopidogrel 75 mg/day with cardiomagnil 75 mg/day (n = 11). All the patients were administered fraxiparin 86 IU/kg sc each 12 hours for 5-8 days.
Results. Group 1 patients showed platelet hyperaggregation, platelet aggregation decreased in groups 2,
3 and 4 (6 patients of group 1 were resistant to aspirin). The highest antiaggregation effect was
achieved in group 5.
Conclusion. Control over antiaggregation treatment in patients with ACS without STSE by monitoring
of platelet function open broad opportunities for selection of effective individual therapy.

参考

  1. Грацианский Н. А. Нестабильная стенокардия - острый коронарный синдром. II. Современное состояние проблемы лечения. Кардиология 1997; 1: 8-23.
  2. Грацианский Н. А. Нестабильная стенокардия - острый коронарный синдром. Некоторые новые факты о патогенезе и их значение для лечения. Кардиология 1996; 11: 4- 16.
  3. Falk E., Shah Р. К., Fuster V. Coronary plaque disruption. Circulation 1995; 92: 657-671.
  4. Libby P. Molecular basis of the acute coronary syndromes. Circulation 1995; 91: 2844-2850.
  5. FIT trialists. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomized trials of more than 1000 patients. Fibrinolytic Therapy Trialists' (FTT) Collaborative Group. Lancet 1994; 343: 311-322.
  6. Schreiber T. L., Macina G., Bunnell P. et al. Unstable angina or non-Q wave infarction despite long-term aspirin: response to thrombolytic therapy with implications on mechanisms. Am.Heart J. 1990; 120:248-255.
  7. Braunwald E., Jones R. H., Mark D. B. et al. Diagnosing and managing unstable angina. Agency for Health Care Policy and Research. Circulation 1994; 90: 613-622.
  8. Лечение острого коронарного синдрома без стойких подъемов сегмента ST на ЭКГ. Российские Рекомендации. Кардиология 2001; 10, прил.: 1-23.
  9. Bertrand М. E., Simoons M. L., Fox К. A. A. Management of acute coronary syndromes in patients presenting without persistent ST segment elevation. The Task Force on the Management of Acute Coronary Syndromes of the European Society of Cardiology. Eur. Heart J. 2002; 23: 1809-1840.
  10. Collaborative overview of randomised trials of antiplatelet therapy, 1: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration. Br. Med. J. 1994; 308: 81-106.
  11. McKee S. A., Sane D. C, Deliazgyris E. N. Aspirin resistance in cardiovascular disease: A review of prevalance, mechanisms, and clinical significance. Thromb. Haemost. 2002; 88: 711-715.
  12. Баркаган 3. С. О двух видах мониторинга антитромботических средств. Бюл. сиб. мед. 2003; 2: 9-13.
  13. Gusu P. A., Kottke-Marchant К., Poggio E. D. et al. Profile and prevalence of aspirin resistance in patients with cardiovascular disease. Am. J. Cardiol. 2001; 88: 230-235.
  14. Mueller M. R., Salat A. et al. Variable platelet response to lowdose ASA. Thromb. Haemost. 1997; 78: 1003-1007.
  15. Zimmerman N., Kienzle P., Winter J. et al. Aspirin resistance after coronary artery bypass grafting. J. Thorac. Cardiovasc Surg. 2001; 121: 982-984.
  16. YusufS., Zhao F., Mehta S. R. et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without iT-segment elevation. N. Engl. J. Med. 2001; 345: 1329-1339.
  17. Баркаган З. С, Момот А. П. Основы диагностики нарушений гемостаза. М.: Медицина; 1999.
  18. Гланц С. Медико-биологическая статистика. М.: Практика; 1999.
  19. Morrow D. A., Amman E. M., Tanasijevic M. et al. Cardiac troponin I for stratification of early outcomes and the efficacy of enoxaparin in unstable angina: a TIMI-11B substudy. J. Am. Coll. Cardiol. 2000; 36: 1812-1817.
  20. Барцева Г. А., Горбачева В. А., Макарова Т. Б., ЩетниковичК. А. Что привнес агрегометр в диагностические возможности КДЛ. Лаборатория 2000; 4: 12-13.
  21. Покровская Е. В., Ваулин Н. А., Грацианский Н. А. и др. Острый коронарный синдром без подъемов сегмента ST на ЭКГ: агрегация тромбоцитов и маркеры воспаления при раннем применении аторвастатина и правастатина. Кардиология 2003; 1:7-18.
  22. Попонина Т. М. Патогенетические аспекты лечения острого коронарного синдрома без подъема сегмента ST. Сиб. мед. журн. 2003; 1-2: 77-83.
  23. Ravn Н. В., Vissinger Я., Kristensen S. D., Husted S. E. Magnesium inhibits platelet activity: an in vitro study. Thromb. Haemost. 1996; 76: 88-93.
  24. Hwang D. L., Yen С. F., Nadler J. L. Effect of extracellular magnesium on platelet activation and intracellular calcium mobilization. Am. J. Hypertens. 1992; 5: 700-706.
  25. Gawaz M., Ott I., Reininger A. J., Neumann F. J. Effects of magnesium on platelet aggregation and adhesion: magnesium modulates surface expression of glycoproteins on platelets in vitro and ex vivo. Thromb. Haemost. 1994; 72: 912-918.
  26. Woods K. L., Fletcher S., Roffe C, Haider Y. Intravenous magnesium sulphate in suspected acute myocardial infarction: resuits of the second Leicester Intravenous Magnesium Intervention Trial (LIM1T-2). Lancet 1992; 339: 1553-1558.
  27. Равн X. Б., Кристенсен С. Д., Хъюордал В. Е. и др. Раннее внутривенное введение сульфата магния подавляет образование артериального тромба. Международ, мед. журн. 1998; 7: 616-621.
  28. Herzog W. R., Atar D., Gurbel P. A. et al. Effect of magnesium sulphate infusion on ex vivo platelet aggregation in swine. Magnes. Res. 1993; 6: 349-353.

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