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Vol 26, No 4 (2020)
Research paper
Published online: 2021-03-22

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Assessment of platelet function and resistance to aspirin and clopidogrel in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty

Grzegorz Borowski1, Aleksandra Nowaczyńska2
Acta Angiologica 2020;26(4):119-128.


Introduction: Analysis of platelet function, acetylsalicylic acid (ASA) and clopidogrel resistance in patients
with peripheral arterial disease (PAD) undergoing percutaneous transluminal angioplasty (PTA), the impact of
procedure on this phenomenon, connection with diabetes, hypertension, smoking.

Material and methods: The study included 72 patients, with a group of patients taking ASA on a permanent
basis and a group of patients in whom treatment was implemented after the procedure. Patients were also
divided according to the antiplatelet therapy applied, either double-therapy, or ASA monotherapy. Daily doses
were 75 mg. Three methods were used for the evaluation of the platelet function: IVY bleeding time, cytometric
evaluation of platelet surface antigen (CD62p and CD63) expression and hemostasis measurement by PFA-200®.

Results: In the PFA-200 analysis, ASA resistance was found in 37.8% (64.7% were tobacco smokers) before
surgery. Patients not taking ASA before, after PTA and first dose of ASA presented resistance in 63%. The first
dose of clopidogrel after surgery was associated with resistance in 73.7%. Significant differences in the expression
of CD62p and CD63 markers before and after PTA were observed. According to IVY method, aspirin resistance
was found in 40% of patients permanently receiving ASA.

Conclusions: Patients with PAD who undergo PTA are resistant to ASA in 40%, smoking is associated with
this phenomenon. PTA increases the expression of CD62P and CD63, and thus the platelet activation, which
is not adequately prevented by antiplatelet drugs at a dose of 75 mg. Dual antiplatelet therapy reduces the
activation of thrombocytes more than the monotherapy of ASA.

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