Author/Authors :
Aksu, Hale Ünal Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Cardiology Department, Turkey , Aksu, Hüseyin Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Cardiology Department, Turkey , Öner, Ender Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Department of Cardiology, Turkey , Işıksaçan, Nilgün Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Biochemistry Department, Turkey , Çelik, Ömer Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Cardiology Department, Turkey , Ertürk, Mehmet Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Department of Cardiology, Turkey , Kalkan, Ali Kemal Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Cardiology Department, Turkey , Satılmışoğlu, Muhammed Hulusi Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital - Cardiology Department, Turkey
Abstract :
Objective: Cardiovascular diseases are the leading cause of death in patients with chronic kidney disease (CKD). There is conflicting evidence about effect of CKD on clopidogrel responsiveness. We aimed to evaluate the clopidogrel responsiveness in CKD patients with acute coronary syndrome (ACS). Methods: A total of 101 patients; 55 with moderate to severe CKD and 46 with normal renal function or mild CKD, hospitalized with ACS were included in our study. Multiplate test was used to determine clopidogrel responsiveness. Platelet aggregation results were presented as aggregation unit (AU)*min and values over 470 AU*min were accepted as clopidogrel low responders. Results: The 101 patients (mean age 64.76±8.67 years; 61 [60.4%] male) were grouped into the two study groups as follows: group 1; 55 patients with eGFR 60 ml/min/1.73 m2 and group 2; 46 patients with eGFR 60 ml/min/1.73 m2. 35 patients (34.7%) of the study population were found to have low response to clopidogrel (16 [34.8%] patients in group 1 and 18 [33.3%] patients in group 2, p=0.879) . There was no significant difference between group 1 and 2 for Multiplate test results (414.67±281.21 vs 421.56±316.19 AU*min, p=0.909). Clopidogrel low responsiveness were independently related to Multiplate test results of aspirin responsiveness (OR=1.004, CI 1.002–1.007, p=0.001) and hemoglobin (OR=0.727, CI 0.571–0.925, p=0.010). Multiplate results were also independently related to Multiplate test results of aspirin responsiveness (β=0.402, p 0.0001) and hemoglobin (β=-0.251, p=0.007). Conclusion: Platelet response to clopidogrel does not differ between patients with eGFR 60 ml/min/1.73 m2 and eGFR 60 ml/min/1.73 m^2.
