Investigation of acetylsalicylic acid resistance in patients with acute coronary syndrome

Background: Aspirin and clopidogrel therapy is the standard of care in patients with acute coronary syndrome (ACS) and stent implantation. However, Clopidogrel and aspirin resistance are arising increasingly. As this nonresponsiveness is associated with increased adverse outcome, detection of these subjects in daily practice is important in order to withhold a more aggressive therapy and closer follow up. The platelet function tests for measurement aspirin and clopidogrel resistance are very expensive and time consuming. We need have practically, easily accessible, cheaper and reliable parameters for detecting aspirin and clopidogrel resistance Methods: A total of 541 patients who had been on clopidogrel and aspirin therapy for the diagnosis of acute coronary syndrome were enrolled in this study. Aspirin resistance was analyzed by Multiplate MP-0120 device by using the method of whole blood aggregometry. The amount of ADP induced platelet aggregation was assessed as area under curve (AUC), and a cut off value of 500 for aspirin resistance, above which the patient is considered as aspirin resistant, was used. Results: Among the 541 patients analyzed, 45 were found aspirin nonresponder (8.5%). Diabetes Mellitus, Hyperlipidemia, calcium levels, platelet levels, were predictory factor for aspirin resistance. Conclusion: This study showed that diabetes mellitus, hyperlipidemia, calcium levels, platelet levels are associated with aspirin resistance especially in patients with ACS