PURPOSE: Metabolic syndrome (Met. Synd.) is known to increase the risk of coronary artery disease (CAD). Clopidogrel is an important antiplatelet therapy that has shown to reduce cardiovascular events in patients with CAD. We sought to determine whether the presence of Met. Synd. affects platelet aggregation inhibition (PAI) in patient receiving clopidogrel therapy.
METHODS: We evaluated PAI in 236 patients treated with clopidogrel prior to elective cardiac catheterization, scheduled for percutaneous intervention. PAI was measured by Platelet Works (Helena Laboratories ICHOR) using ADP 20μmol as an agonist. The principle of the ICHOR is based on a simple platelet counter, done on blood specimen obtained in EDTA tubes that will serve as baseline and in ADP pretreated tubes (20 mg) which will reveal a decreased platelet count while compared with the baseline. The amount of the decrease in platelet count depends on the amount of the platelets that aggregated secondary to the activation from the ADP. PAI was calculated as follows:PAI = Plt (ADP tube) × 100/ Plt (EDTA tube)Blood specimens were obtained after the arterial sheath placement and run through the ICHOR within 30 minutes from collection. Clopidogrel non-responsiveness was defined as a PAI of < 35%.
RESULTS: Based on the PAI distribution curve, patients were divided into four quartiles. Patients were classified in two groups based on the presence or absence of Met. Synd . Met. Synd. defined by patient having three out of the five components (fasting blood sugar, triglyceride level, central obesity, HDL level, and blood pressure). Chi square test with Yates correction was used to compare the two groups in all quartiles of PAI. There was no significant difference in PAI or clopidogrel non-responders between the two groups.
CONCLUSION: Metabolic syndrome does not seem to alter the PAI in patients on clopidogrel therapy, as measured with Platelet Works (Helena Laboratories ICHOR) using ADP 20μmol as an agonist.
CLINICAL IMPLICATIONS: Patietns with Metabolic syndrome do not have an decreased PAI compared to patients without metabolic syndrome.
DISCLOSURE: Sotir Polena, No Financial Disclosure Information; No Product/Research Disclosure Information