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

Paul, Rudrajit; Banerjee, Amit Kumar; Guha, Shantanu; Chaudhuri, Utpal; Ghosh, Sayantani; Mondal, Jayati; Bandyopadhyay, Ranjana

doi:10.4103/2229-516x.117086

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…Such data suggest that diabetes is associated with considerable resistance to aspirin and clopidogrel therapy, and such insufficient antiplatelet responses could be an underlying causal factor for the frequent END observed in this population. In accordance with the elevated fibrinogen levels in our data, a recent study evaluating platelet aggregation characteristics in acute coronary syndrome found antiplatelet drug resistance to be significantly associated with metabolic syndrome, and fibrinogen levels and high sensitivity-CRP were higher in this population [ 37 ]. Serum fibrinogen levels appeared to be strongly associated with drug resistance [ 37 ].…”

Section: Discussionsupporting

confidence: 90%

Association of fibrinogen level with early neurological deterioration among acute ischemic stroke patients with diabetes

Lee

Kang

et al. 2017

BMC Neurol

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BackgroundDiabetes mellitus (DM) is a risk factor for early neurological deterioration (END) in acute ischemic stroke. The prothrombotic protein fibrinogen is frequently elevated in patients with diabetes, and may be associated with poorer prognoses. We evaluated whether fibrinogen is associated with END in patients with diabetes after acute ischemic stroke.MethodsWe included 3814 patients from a single hospital database admitted within 72 h of onset of ischemic stroke. END was defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) ≥2 within 7 days post-admission. In the total population (END, n = 661; non-END, n = 3153), univariate and multivariate analyses were performed to assess fibrinogen as an independent predictor for END. We then performed propensity score matching and univariate analyses for DM (END, n = 261; non-END, n = 522) and non-DM populations (END, n = 399; non-END, n = 798). Multiple logistic analyses were performed after matching for fibrinogen as a risk factor in each subgroup.ResultsFibrinogen levels were higher in the END group than in the non-END group (367 ± 156 mg/dL vs. 347 ± 122 mg/dL, p = 0.002), though they were not associated with END in logistic regression analyses. Fibrinogen levels were found to be an independent predictor for END, but only in the DM population (fibrinogen levels 300–599 mg/dL, odds ratio: 1.618, 95% confidence interval: 1.037–2.525, p = 0.034, fibrinogen levels ≥600 mg/dL, 2.575, 1.018–6.514, p = 0.046; non-DM population, p = 0.393). The diabetes-fibrinogen interaction for the entire cohort was p = 0.101.ConclusionsElevated fibrinogen is dose-dependently associated with END in patients with diabetes following acute ischemic stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-017-0865-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Association of fibrinogen level with early neurological deterioration among acute ischemic stroke patients with diabetes

Lee

Kang

et al. 2017

BMC Neurol

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“…High levels of resistance to antiplatelet drugs were determined in MS patients. ACS patients without MS also showed this resistance to a significant degree ( 17 ). In 2009 Massie BM et al carried out the treatment applying warfarin and clopidogrel or aspirin during a period of 30 months.…”

Section: Discussionmentioning

confidence: 94%

Evaluation of Aggregometery Parameters and Efficacy of Plavix versus Clopidex in Patients Suffering from Ischemic Heart Disease: A Randomized Double Blind Clinical Trial

Shohrati¹,

Moshkani²,

Pishgoo³

et al. 2014

Iran Red Crescent Med J

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Background:Ischemic heart disease is the leading cause of death in most societies. In a pathophysiologic point of view, it chiefly results from the formation of thrombus in coronary arteries which could not be only prevented by aspirin. Many of clinical trials have shown the long-term benefits of antiplatelet drugs in reducing the risk of thrombotic accidents.Objectives:Clopidogrel is a thienopyridine derivative used to prevent platelets from adhering together by direct inhibition of Adenosine diphosphate (ADP), the major factor behind platelets aggregation. Sanofi-Aventis and Bristol-Myers are companies that produce Clopidogrel by the name of Clopidogrel bisulfate. Its trade name is Plavix, nonetheless in Iran it is distributed under the name of Clopidex by Exir Company. In this study we are to compare Plavix and Clopidex in terms of efficacy as well as aggregometry parameters like ADP and PRP (Platelet Rich Plasma).Patients and Methods:This is a double blind clinical trial in which we had two groups of patients suffering from Ischemic heart disease who were selected by inclusion criteria. Group A (36 patients) took Plavix (75 mg/d) and group B (36 patients) used clopidex (75 mg/d) both for 30 days. The aggregometry parameters also consisted of PRP and ADP that were run on the patients before and after the study. Finally, a comparison of aforementioned tests, quality of life, lab parameters and compliance in both groups was provided.Results:In groups A and B, the mean levels of PRP before the study were 348000 and 340000/µL respectively. The ADPs were also 73/76 and 68/07 µM that showed no significant difference (P > 0.05).The Means of ADP5 in group A before and after the study were 66.40 and 43.84 µM respectively that there was significant difference (P = 0.001). The Means of ADP5 in group B before and after the study were 58.04 and 40.16 µM respectively that there was significant difference (P < 0.001).The Means of ADP20 in group A before and after the study were 73.76 and 54.97 µM respectively which showed significant difference (P < 0.001). The Means of ADP20 in group B before and after the study were 68.07 and 52.49 µM respectively which showed significant difference (P = 0.001). Difference of ADP5 between group A and B was not significant (P = 0.495). Difference of ADP20 between group A and B was not significant (P = 0.721). The Means of PRP in group A before and after the study were 348000 and 335000/ µL respectively that there was no significant difference (P = 0.66). The Means of PRP in group B before and after the study were 340000 and 336000/ µL respectively that indicated no significant difference (P = 0.81). Difference of PRP between group A and B was not significant (P = 0.563).Conclusions:Our findings suggested that both drugs significantly lessen the ADP level; even so there was no significant difference between two groups in PRP and ADP factors.

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“…On the other hand, platelets do have direct collagen receptors (GP VI and integrin α2β1) on their surface that does not require vWf for collagen binding with GP VI playing a major role in platelet activation upon collagen binding. Collagen was applied in these experiments in similar concentration as used in light transmission aggregometry . It is possible that—despite the intentionally lowered platelet count in samples—collagen actually triggered platelet aggregation.…”

Section: Discussionmentioning

confidence: 99%

“…Collagen was applied in these experiments in similar concentration as used in light transmission aggregometry. 17 It is possible that-despite the intentionally lowered platelet count in samples-collagen actually triggered platelet aggregation. The total surface of platelet aggregates is much smaller than the combined surface of individual adhering platelets which accounts for the decrease in impedance.…”

Section: Impedimetric Platelet Adhesion and Spreading Measurementsmentioning

confidence: 99%

Platelet impedance adhesiometry: A novel technique for the measurement of platelet adhesion and spreading

Polgár

Soós

Lajkó

et al. 2018

Int J Lab Hematology

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

Cited by 10 publications

References 20 publications

Association of fibrinogen level with early neurological deterioration among acute ischemic stroke patients with diabetes

Association of fibrinogen level with early neurological deterioration among acute ischemic stroke patients with diabetes

Evaluation of Aggregometery Parameters and Efficacy of Plavix versus Clopidex in Patients Suffering from Ischemic Heart Disease: A Randomized Double Blind Clinical Trial

Platelet impedance adhesiometry: A novel technique for the measurement of platelet adhesion and spreading

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