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Year : 2013  |  Volume : 3  |  Issue : 2  |  Page : 117-121

Study of platelet aggregation in acute coronary syndrome with special reference to metabolic syndrome

1 Department of Medicine, Medical College, Kolkata, India
2 Department of Cardiology, Medical College, Kolkata, India
3 Department of Clinical Hematology, Institute of Hematology and Transfusion Medicine, Kolkata, India
4 Department of Medicine, Midnapore Medical College, Midnapore, West Bengal, India
5 Department of Gynecology and Obstetrics, Medical College, Kolkata, India

Correspondence Address:
Rudrajit Paul
15/5 Bose Pukur Road, Kolkata 700 039, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2229-516X.117086

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Background/Context: Antiplatelet drug resistance increases the risk of adverse events like stent thrombosis in acute coronary syndrome (ACS). Metabolic syndrome (MS) is a prothrombotic state and presence of MS further increases the risk of antiplatelet drug resistance. Aims and Objectives: We studied platelet aggregation characteristics in patients of ACS for aspirin or clopidogrel resistance. We studied the relation of drug resistance with blood markers like high sensitivity C-reactive protein (hsCRP). We also studied for any relation of drug resistance with presence of MS. Materials and Methods: We studied platelet aggregation characteristics by optical aggregometry using platelet-rich plasma (PRP) of patients. Collagen (2 μg/mL) and adenosine diphosphate (ADP; 10 μmol) were used. Greater than 50% aggregation in PRP of patients was taken as an evidence of drug resistance. Suitable blood tests were done including newer risk markers like hsCRP, apolipoprotein B, and fibrinogen. Statistical test: Statistical tests included Student's t-test and Kendall's rank correlation coefficient. Results: We had a total of 94 patients of ACS with 47 (50%) having MS. MS patients showed higher blood levels of hsCRP and fibrinogen. Twenty-eight (59.5%) patients with MS showed antiplatelet drug resistance compared to 12 patients without MS. Serum fibrinogen showed strongest correlation with drug resistance. HsCRP levels showed correlation with aspirin resistance (r = 0.53) only in the MS group. Discussion and Conclusion: We found significantly high prevalence of antiplatelet drug resistance. Aspirin and clopidogrel resistance was comparable. MS was a significant risk factor for drug resistance. The prothrombotic and proinflammatory markers showed strong correlation with drug resistance. A larger randomized trial is needed to better characterize this clinical problem.

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