Sigara kulanımının klopidogrel tedavisi alan hastalarda P2Y12 trombosit fonksiyon testi ile değerlendirilen trombosit reaktivitesi üzerine etkisi

Amaç: Sigara içimi ve trombosit fonksiyon testinin etkinliği arasındaki etkileşim kesin olarak gösterilmemiştir. Bu çalışmada klopidogrel ile tedavi edilen hastalarda sigara içiminin P2Y12 trombosit fonksiyon testi ile belirlenen trombosit reaktivitesi üzerine etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Bu prospektif çalışmaya daha önce stent implantasyonu yapılan ve klopidogrel kullanan 200 hasta dahil edildi. Bu hastalara göğüs ağrısı nedeniyle tanısal koroner anjiyografi yapıldı ve klopidogrel rezistans testi uygulandı. Ayrıca, trombosit reaktivitesi üzerindeki sigara etkisi araştırıldı. Bulgular: P2Y12 trombosit fonksiyon testi ile hastaların% 17'sinin (34/200) klopidogrel dirençli olduğunu bulduk. Anjiyografik stent restenoz ile klopidogrel direnci arasında ilişki tespit etmedik (p > 0.05). Ancak sigara içme ve klopidogrel direnci arasında istatistiksel olarak anlamlı ilişki vardı. Yine sigara içenlerde VerifyNow P2Y12 testiyle tespit edilen trombosit reaktivite seviyeleri de yüksekti (> 208 PRU). Sonuç: Sigara içenlerde P2Y12 trombosit fonksiyon testi ile tespit ettiğimiz klopidogrel direnci beklendiği gibi stent restenoz oranlarında yükseklik ile paralellik göstermedi. Bu yüzden sigara içenlerde P2Y12 trombosit fonksiyon testi klinik bulgularla uyumlu olan net sonuçlar vermeyebilir.

Anahtar Kelimeler:

Klopidogrel direnci, koroner arter hastalığı, sigara kullanımı

The Effect Of Smoking On Platelet Reactivity Assessed By P2Y12 Platelet Function Testing In Patient With Clopidogrel Therapy

Aim: The interaction between cigarette smoking and efficacy of platelet function testing is not definitely shown. We aimed to conduct the effects of smoking on platelet reactivity by P2Y12 platelet function testing on the patients treated with clopidogrel. Materials and Methods: This prospective study contained 200 patients who underwent a previous stent implantation. Diagnostic coronary angiography was performed those patients due to chest pain. The clopidogrel resistance test was applied. Furthermore, the smoking effect on platelet reactivity was investigated. Results: We found that 17% of the patients (34/200) clopidogrel-resistant by P2Y12 platelet function test. We didn’t find any relationship between angiographic stent restenosis and clopidogrel resistance (p>0.05). There was statistically significant relationship between smoking and clopidogrel resistance. The smokers had also higher platelet reactivity level (>208 PRUs) as revealed by VerifyNow P2Y12 assay. Conclusion: The test results achieved through the clopidogrel resistance by P2Y12 platelet function testing did not meet expectation with the angiographically observations. Therefore, P2Y12 platelet function testing can be unclear in smoker patients.

Keywords:

Clopidogrel resistance, coronary artery disease, smoking,

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