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Increased aggregation response despite antiplatelet therapy may be an additional risk factor particularly in women with microvascular dysfunction (MVD).
In 80 women (age 57,3 ± 6,2 years) who were hospitalized with acute coronary syndromes without segment elevation ST (NSTACS), were assessed the extent of platelet aggregation with arachidonic acid (AA) in a concentration of 0.5 mg / ml, and adenosine diphosphate (ADP) a concentration of 5 mmol / L in the 1st and the 10th day after the first loading dose of aspirin 325 mg / day and 300 mg / day of clopidogrel. On the 7 th day of all patients was performed coronary angiography, the results of which has been allocated a group (n = 44) with established coronary heart disease (CHD) and a group (n = 36) with MVD.
In patients with both of MVD and with CHD showed a significant increase in the aggregation activity, including spontaneous (without added inducers) compared with healthy as at 1st and on 10th day of the study. Platelet aggregation had significantly higher level in group with MVD. In dynamics, to the 10th-day of the disease, a decrease extent of platelet aggregation in the group with the MVD, and in the group with CHD. In this case, values [[Unable to Display Character: ​]][[Unable to Display Character: ​]]were significantly higher in the MVD (p <0.01)
Platelet aggregation was significantly higher (p <0.01) in women with MVD in comparison with CHD receiving antiplatelets therapy
The extent of platelet aggregation (in%)
|Inductor||Control (n=40)||MVD (n=36)||CHD (n=44)||MVD (n=36)||CHD (n=44)|
|1st day||10th day|
|AA 0.5 mg/ml||7,5±2,4||55,6±2,5*||50,95±1,5*,#||35,6±1,1*||23,9±1,2*,#|
|ADP 5 mmol/l||11,6±3,3||65,3±2,1*||62,4±3,2 *,#||55,3±2,4*||49,3±2,1 *,#|
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Gender, Dissection, Outcomes from ACS
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1170–199
- 2013 American College of Cardiology Foundation