title: Thrombin generation test for evaluation of antiplatelet treatment in patients with coronary artery disease after percutaneous coronary intervention.
abstract: To study the possibility of using thrombin generation tests in platelet-rich and platelet-poor plasma for evaluation of dual antiplatelet therapy efficacy in patients with coronary artery disease (CAD), following percutaneous coronary intervention. Venous blood was analyzed from CAD patients aged 53-75 years who had undergone percutaneous coronary intervention with stenting within one year and had been receiving standard doses of clopidogrel and aspirin (75 and 75-100 mg per day, respectively). The control group comprised age- and sex-matched subjects without clinical signs of CAD who were not receiving these drugs. Thrombin generation tests were performed in platelet-rich and platelet-poor plasma. Intravascular platelet activation, induced platelet aggregation, and routine coagulation were evaluated. Antiplatelet treatment did not influence results of routine coagulation tests or intravascular platelet activation. The dual antiplatelet therapy affects collagen-induced platelet aggregation (44 ± 2.5 vs. 7.9 ± 2.6%, р = 10-7) and leads to decreases in endogenous thrombin potential (1900 ± 85 vs. 1740 ± 95 nM∙min, p = 0.0045), maximum thrombin concentration (134 ± 9.5 vs. 106 ± 6.5 nM, p = 4∙10-6), and increases in time to peak thrombin (27 ± 1.5 vs. 31 ± 2 min, p = 0.0012). Decreases in thrombin generation rate showed the highest statistical significance (13 ± 2 vs. 7.9 ± 0.8 nM/min, p = 10-8). Antiplatelet treatment did not alter thrombogram parameters for platelet-poor plasma.
authors.affiliation: a Department of Faculty Therapy , Pavlov First Saint-Petersburg State Medical University , Saint-Petersburg , Russia.|b Department of Acute Coronary Syndrome , Federal Almazov North-West Medical Research Centre , Saint-Petersburg , Russia.
authors.forename: Gelena
authors.initials: G
authors.lastname: Berezovskaya
authors.affiliation: c Department of Blood Coagulation , Russian Research Institute of Hematology and Transfusiology , Saint-Petersburg , Russia.
authors.forename: Olga
authors.initials: O
authors.lastname: Smirnova
authors.affiliation: d Department of Connective Tissue Disorders , Federal Almazov North-West Medical Research Centre , Saint-Petersburg , Russia.
authors.forename: Eduard
authors.initials: E
authors.lastname: Malev
authors.affiliation: e Department of Physics, Mathematics and Computer Science , Pavlov First Saint-Petersburg State Medical University , Saint-Petersburg , Russia.
authors.forename: Nikita
authors.initials: N
authors.lastname: Khromov-Borisov
authors.affiliation: f Department of Ultrasound Diagnostics , Federal Almazov North-West Medical Research Centre , Saint-Petersburg , Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Klokova
authors.affiliation: g Department of Clinical Angiology , Federal Almazov North-West Medical Research Centre , Saint-Petersburg , Russia.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Karpenko
authors.affiliation: c Department of Blood Coagulation , Russian Research Institute of Hematology and Transfusiology , Saint-Petersburg , Russia.
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Papayan
authors.affiliation: h Department of Pathological Physiology , Pavlov First Saint-Petersburg State Medical University , Saint-Petersburg , Russia.
authors.forename: Nikolay
authors.initials: N
authors.lastname: Petrishchev
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D013917:Thrombin / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D013917:Thrombin
keywords: Antiplatelet drugs; coronary artery disease; percutaneous coronary intervention; thrombin generation test