Koroner arter hastalığı saptanan hastalarda PFA-100 sistemi ile aspirin direnci sıklığının araştırılması
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Date
2006
Authors
Karaağaç, Kemal
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Publisher
Uludağ Üniversitesi
Abstract
Aspirin günümüzde en yaygın kullanılan antitrombotik ilaçtır. Aspirin kullanılmasına rağmen tıkayıcı vasküler olayların ortaya çıkması ve laboratuvar araştırmalarında trombosit fonksiyonlarının, aspirine normal cevap verenlere göre yeterince inhibe edilmediğinin gösterilmesi “aspirin direnci” olarak tanımlanmıştır. Çalışmamızda koroner arter hastalığı (KAH) saptanan olgularda PFA-100 sistemiyle aspirin direnci deerlendirildi. Çal0mamza en az 4 hafta süre ile düzenli olarak, 100 mg ve daha fazla Aspirin kullanan koroner anjiyografisi yapılan 97 hasta dahil edildi. Hastalarda PFA-100 sistemini kullanılarak aspirin direncini saptandı. Tüm olgularımız aspirine yanıt bakımından karşılaştırıldığında KAH saptananlarda, saptanmayanlara göre aspirin direnci anlamlı derecede yüksek bulundu (p:0,02). KAH saptanan aspirine dirençli grupta, sigara içiciliği (p:0.001) daha fazlaydı, LDL-K değerleri (p:0,02) ve T.Kol/HDL kolesterol (p:0,02) değerleri aspirine duyarlı gruba göre anlamlı derecede yüksekti. KAH saptananlarda aspirin direnci olanlar kullandıkları aspirin dozu (100mg ve 300mg) açısından karşılaştırıldıklarında iki grup arasında istatistiksel açıdan anlamlı bir fark saptanmamıştır (p:0,46). KAH saptanan olgular tek damar hastalığı olanlar 1.grup (n:21, %35), iki damar hastalığı olanlar 2.grup (n:16, %26) ve üç damar hastalığı olanlar 3.grup (n:23, %38) olmak üzere üç gruba ayrıldı. Hasta gruplarından tek damar ile iki damar hastalığı olanlar (p:0.26), tek damar ile üç damar hastalığı olanlar (p:0,8) ve iki damar ile üç damar hastalığı olanlar (p:0,35) aspirin direnci açısından aralarında karşılaştırıldıklarında istatistiksel olarak anlamlı farklılık saptanmamıştır. Sonuç olarak, aspirin tedavisi alan hastalarda cevabın benzer olmadığı gösterildi. KAH saptanan olgularda aspirin cevabının yeterliliğinin her hastada PFA-100 sistemi ile kısa sürede değerlendirilip tedavinin bu sonuçlara göre düzenlenebileceği kanaatine varıldı.
Today aspirin is the most widely used antithrombotic drug. Occurance of occlusive vascular events, in the laboratory studies failure of suppression of thrombocyte functions compared to cases that normally respond to aspirin has been defined as aspirin resistance. 2n this study aspirin resistance was evaluated in coronary artery disease patients with PFA-100 system. In the study 97 patients that routinely used 100 mg or higher aspirin for four weeks and that had coronary angiograhic examination were included. 2n the cases with PFA-100 system aspirin resistance was determined. When all the cases were examined in case of aspirin resistance, it was more frequent in the cases with coronary artey disease (p:0,02). In the group with coronary artery disease (60 patients), patients with aspirin resistance more frequently smoked smoking (p:0.001), and the LDL-C values (p:0,02) and T.Chol/HDL cholesterol levels (p:0,02) were significantly higher compared to the aspirin sensitive patients. When the cases with CAD were compared according to the aspirin dose they had (100mg ve 300mg) the two groups did not differ significantly (p:0,46). The patients with CAD were divided into three goups accordng to the number of dseased vessels. Group 1 was constituted of cases with one vessel disease (n:21, %35), group 2 two vessel disease (n:16, %26) and group 3 was constituted of patients with three vessel disease (n:23, %38). There no was statistically significant difference in terms of aspirin resistance between the groups 1 and 2 (p:0.26); 1 and 3 (p:0,8); and the groups 2 and 3 (p:0,35). As a result, it was shown that the responses were not the same in patients taking aspirin. It was concluded tahat in cases with CAD adequacy of aspirin response may be quickly evaluated by PFA-100 system and the therapy may be adjusted according to the results.
Today aspirin is the most widely used antithrombotic drug. Occurance of occlusive vascular events, in the laboratory studies failure of suppression of thrombocyte functions compared to cases that normally respond to aspirin has been defined as aspirin resistance. 2n this study aspirin resistance was evaluated in coronary artery disease patients with PFA-100 system. In the study 97 patients that routinely used 100 mg or higher aspirin for four weeks and that had coronary angiograhic examination were included. 2n the cases with PFA-100 system aspirin resistance was determined. When all the cases were examined in case of aspirin resistance, it was more frequent in the cases with coronary artey disease (p:0,02). In the group with coronary artery disease (60 patients), patients with aspirin resistance more frequently smoked smoking (p:0.001), and the LDL-C values (p:0,02) and T.Chol/HDL cholesterol levels (p:0,02) were significantly higher compared to the aspirin sensitive patients. When the cases with CAD were compared according to the aspirin dose they had (100mg ve 300mg) the two groups did not differ significantly (p:0,46). The patients with CAD were divided into three goups accordng to the number of dseased vessels. Group 1 was constituted of cases with one vessel disease (n:21, %35), group 2 two vessel disease (n:16, %26) and group 3 was constituted of patients with three vessel disease (n:23, %38). There no was statistically significant difference in terms of aspirin resistance between the groups 1 and 2 (p:0.26); 1 and 3 (p:0,8); and the groups 2 and 3 (p:0,35). As a result, it was shown that the responses were not the same in patients taking aspirin. It was concluded tahat in cases with CAD adequacy of aspirin response may be quickly evaluated by PFA-100 system and the therapy may be adjusted according to the results.
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Keywords
Koroner arter hastalığı, Aspirin direnci, PFA-100 sistemi, Coronary artery disease, Aspirin resistance, PFA-100 system
Citation
Karaağaç, K. (2006). Koroner arter hastalığı saptanan hastalarda PFA-100 sistemi ile aspirin direnci sıklığının araştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.