SCREENING SELECTION OF PATIENTS WITH STABLE STENOCARDIA AFTER PERCUTANEOUS CORONARY INTERVENTION FOR AGGREGOMETRY

Objective. To develop a method for screening selection of patients with stable stenocardia (SS) after the planned percutaneous coronary intervention (PCI) for aggregometry.

Materials and methods. 100 SS patients were examined. They received double antiplatelet therapy (DAPT) of 75 mg of acetylsalicylic acid (ASA) and 75 mg of clopidogrel. The data obtained (clinical, aggregometry, C-reactive protein (CRP), fibrinogen, blood test and platelet indices) was analyzed using the STATISTICA 10.0 program.

Results. 45% of patients were identified to have an insufficient response to DAPT. Predictors associated significantly with an insufficient response to DAPT were specified. The cutoff thresholds for predictors were calculated using the ROC analysis: they were the male gender, angina pectoris FC II, body mass index 31.1 kg/m2, one cigarette smoked per day, blood glucose 5.9 mmol/L, and CRP 5.0 mg/L, ESR 13 mm/h, mean platelet volume (MPV) 9.5 fl, large platelet ratio
(P-LCR) 29.9%, thrombocrit (PCT) 0.203%. A screening model for determining the probability of increased aggregatogram values was constructed where 1 point was used for each predictor exceeding the cutoff threshold. When a patient gained
³6 points the probability of the DAPT insufficient response was high and such patients required undergo aggregometry. When a patient gained <6 points — the probability of the DAPT insufficient response was low and aggregometry not required. The method sensitivity was 71.4%, specificity 74.1%, accuracy 80.6%.

Conclusion. The method developed for screening selection of SS patients SS after PCI for aggregometry will allow identifying individuals at high risk of an insufficient response to DAPT, reducing of expenses on unjustified aggregometry, and adjusting DAPT thus reducing the risk of cardiovascular complications developing.

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Автор(ы): T. P. Pronko, V. A. Snezhitskiy, A. V. Kapytski