title: Evaluation of Aspirin and Clopidogrel resistance in patients with Acute Coronary Syndrome by using Adenosine Diposphate Test and Aspirin Test.
abstract: OBJECTIVE
  To evaluate Aspirin and Clopidogrel resistance/non-responders in patients with acute coronary syndrome (ACS) by using adenosine diposphate and aspirin tests.
  
  
  METHODS
  In the study patients with ACS loaded with 300 mg of clopidogrel and 300 mg aspirin and patients on stable daily dose of 75 mg of clopidogrel (more than 3 days) underwent PCI. Response to clopidogrel and Aspirin was assessed by Adenosine Diphosphate (ADP) Test (20 µmol/L) and Aspirin Test (Acetyl Acid) (ASP) 20 µmol/L, respectively, using the Multiplate Platelet Function Analyzer (Dynabyte Medical, Munich, Germany).
  
  
  RESULTS
  Sixty four patients were included in this study out of which 57 were with ACS and 7 scheduled for percutaneous coronary intervention (PCI) electively. The proportion of Aspirin good responders and adequate responders were 76.56% and 18.75%, respectively while adequate response and good response to Clopidogrel accounted for 29.7 and 48.4%, respectively Hyperlipidaemia was only co-morbidity associated with higher AUC ADP value (p: 0.046). Hypertriglyceridaemia and serum calcium were weakly correlated with higher AUC ADP serum calcium r=0.08, triglyceride r=0.12. Patients admitted for scheduled PCI and on stable dose of 75mg clopidogrel exhibited lower AUC ADP value as compared to those admitted with acute coronary syndrome given loading dose of 300mg of Clopidogrel. Post loading dose measurement of anti-platelet therapy among ACS patients using the Multiplate Platelet Function Analyzer showed comparable results with other methods. Conclusions : As determined by Multiplate Platelet Function Analyzer, Aspirin resistance/non-responders in this study in acute coronary syndrome patients accounted for 4.69% while Non-responders in Clopidogrel was 21.9%.
authors.affiliation: Ibrahim O, Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Cheras 56000, Kula Lumpur, alaysia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: O
authors.affiliation: Oteh M, Consultant Cardiologist, Unit Cardiology, Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Cheras 56000, Kula Lumpur, alaysia.
authors.forename: Oteh
authors.initials: O
authors.lastname: M
authors.affiliation: A Syukur A, Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Cheras 56000, Kula Lumpur, alaysia.
authors.forename: A Syukur
authors.initials: AS
authors.lastname: A
authors.affiliation: Che Hassan HH, Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Cheras 56000, Kula Lumpur, alaysia.
authors.forename: Che Hassan
authors.initials: CH
authors.lastname: Hh
authors.affiliation: S Fadilah W, Consultant Haematologist and Head, Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Cheras 56000, Kula Lumpur, alaysia.
authors.forename: S Fadilah
authors.initials: SF
authors.lastname: W
authors.affiliation: MM Rahman, Professor, Department of Medical Microbiology & Immunology, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Cheras 56000, Kula Lumpur, alaysia.
authors.forename: Mm
authors.initials: M
authors.lastname: Rahman
keywords: Acute coronary syndromes; Anti-platelet therapy; Aspirin; Clopidogrel; Hyperlipidaemia