ADP-Induced Recalcified Blood Clotting Time as a Marker of Rethrombosis Risk and Effectiveness of Antiplatelet Therapy in Acute Coronary Syndrome

• Published in: Kardiologiia Vol. 58; no. 6; p. 5
• Main Authors: Malinova, L I, Furman, N V, Dolotovskaya, P V, Chernousova, L A, Denisova, T P
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 01-01-2018
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - complications; Acute Coronary Syndrome - drug therapy; Adenosine Diphosphate - blood; Adult; Aspirin - therapeutic use; Biomarkers; Humans; Male; Platelet Aggregation Inhibitors - adverse effects; Platelet Aggregation Inhibitors - therapeutic use; Recurrence; Risk Factors; Thrombosis - etiology; Thrombosis - prevention & control; Whole Blood Coagulation Time; acute coronary syndrome; antiplatelet therapy; aggregometry; prognosis; monitoring treatment effectiveness
• ISSN: 0022-9040
• DOI: 10.18087/cardio.2018.6.10128

to assess the possibility of the use of ADP induced blood-clotting time measurement in clinical practice prognostication of the course of acute coronary syndrome (ACS) and assessment of effectiveness of antiplatelet therapy (APT).
We enrolled in the study 163 male patients admitted to the coronary unit for acute coronary syndrome (ACS) and 38 male practically healthy volunteers (PHV). ADP induced blood-clotting time (ADP BCT) was measured as time (sec) between addition of ADP (10 μcmol) to recalcificated sample of citrate blood and clot formation. In healthy volunteers ADP BCT was determined before and 45 minutes after oral administration of acetylsalicylic acid (ASA, 250 mg). Risk of cardiovascular death was calculated using the GRACE score. Platelet function tests were performed by optical aggregometry. Follow-up period for patients with ACS was 24 months. The primary end point (PEP) was the composite of cardiovascular death and rehospitalization.
In ACS patients ADP BCT was significantly lower than in PHV: 134.8 (109.9; 161.3) vs 85.7 (60.5; 108.7) sec, p=0.015. In PHV ASA increased ADP BCT - 103.2 (95.1; 130.7) vs 133.1 (102.8; 154.3) sec, p=0.041. ADP BCT correlated with age in both PHV and patients (R= -0.431, p.