Isparta ve çevresinde klopidogrel direncinin araştırılması

Year 2019, Volume: 26 Issue: 4, 416 - 422, 01.12.2019

Fatih Aksoy , Hasan Aydın Baş , Ali Bağcı Bayram Ali Uysal , Seda Aksoy Ercan Varol , Ahmet Altınbaş

https://doi.org/10.17343/sdutfd.507410

Abstract

Giriş ve amaç: Akut koroner sendrom (AKS) ile başvuran ve/veya
stent uygulanan hastalarda klopidogrel tedavisi günümüzde standart tedavidir.
Bununla beraber klopidogrel tedavisine yanıtsızlık olumsuz sonuçlarla ilişkili
olması nedeni ile günümüzde önemli bir sorundur. Antitrombositer ilaçların
etkinliğini ölçmek için kullanılan trombosit fonksiyon testleri çoğu kez
pahalı, zaman alıcı ve ulaşılması zor testlerdir. Klopidogrel direncini
saptamak için pratik, kolay uygulanabilinir, ucuz ve güvenilir parametrelere
ihtiyaç vardır.

Materyal-Metot: Akut Koroner Sendrom tanısı ile klopidogrel
kullanan 531 hasta çalışmaya alındı. Alınan kan örneklerinde MEA (multiple
electrod aggregometry) ile çalışıldı. Sonuçlar eğri altında kalan alan (AUC)
cinsiden verildi. AUC > 470 olması klopidogrel direci,  olarak yorumlandı.

Bulgular:       Toplamda
65  (% 12,2)  hastada klopidogrel direnci saptandı. Kadın
hastalarda klopidogrel direnci anlamlı olarak fazlaydı (P= 0,005). Risk
faktörlerine bakıldığında ise hiperlipidemik ve diyabetik hastalarda
klopidogrel direnci daha fazla görülürken, sigara içenlerde direnç daha az
görülmekteydi (p= 0,016, p< 0,001, p= 0,046). Klopidogrel direnci olan
hastalarda kalsiyum seviyesi, trombosit sayısı ve vücut kitle indeksi daha
yüksek bulundu.   

Sonuç: Bu çalışma, vücut kitle indeksi, diyabet, hiperlipidemi,
kadın cinsiyet’in klopidogrel direnci açısından bir risk faktörü olabileceğini
ortaya koymuştur. 

Keywords

Akut koroner sendrom, klopidogrel direnci, Isparta

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