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The antiplatelet therapy and pro-inflammatory cytokines with stable coronary artery disease: is there any connection?

Session Poster Session 1

Speaker Andrey Vorobev

Congress : Heart Failure 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease - Pathophysiology and Mechanisms
  • Session type : Poster Session
  • FP Number : P498

Authors : A Vorobev (Ulyanovsk,RU), VI Ruzov (Ulyanovsk,RU), LG Komarova (Ulyanovsk,RU), AS Komarov (Ulyanovsk,RU)

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Authors:
A Vorobev1 , VI Ruzov1 , LG Komarova1 , AS Komarov1 , 1Ulyanovsk State University - Ulyanovsk - Russian Federation ,

Citation:

The connection between cytokine inflammation and atherothrombosis suggests evaluability of

the antiplatelet effect by values of pro-inflammatory interleukins, notably IL-1ß and IL-6.

Purpose. The goal is to study the connection between the antiplatelet effect and cytokine

inflammation with stable CAD.

Methods. The evaluation of thrombocyte aggregation against mono- and dual antiplatelet therapy

was carried out in 147 patients with stable clinical progression of CAD, of whom 121 patients

received aspirin mono-therapy, while 26 patients received clopidogrel/aspirin therapy. The

platelet aggregation was assessed by a spontaneous and adenosine diphosphate (ADP) - induced

aggregometry. IL-1ß and IL-6 concentration was determined by a solid-phase enzyme

immunoassay.

Results. The stable progression of CAD is characterized by the absence of activation of cytokine

inflammation (in IL-1ß and IL-6 levels) in 73% of patients. Subclinical inflammation was seen in

23% of patients during both mono- and dual antiplatelet therapy, which was reflected by higher-

than-normal values of predominantly IL-6 (12% vs. 1%).

Evaluation of the connection between the cytokine activity and the spontaneous and ADP-

induced platelet aggregation in patients undergoing coronary revascularization showed

insufficient anti-inflammatory effect of aspirin mono-therapy vs. the combined effect of aspirin

and clopidogrel, which was expressed by higher levels of pro-inflammatory interleukins IL-1ß

and IL-6 (?2=4.01, p=0.04). At the same time, spontaneous platelet aggregation activity was

observed during mono or double antiplatelet therapy, mainly in stented patients (23%) vs.

shunting patients (7%), and correlated with higher-than-normal values of pro-inflammatory

interleukins.

Conclusion. The efficacy of antiplatelet therapy correlates with low ADP-induced platelet

activity and cytokine inflammation. Persistence of high spontaneous platelet aggregation during

antiplatelet therapy, mainly in stented patients, against the higher-than-normal values of pro-

inflammatory interleukins indicates subclinical inflammation and thrombogenic risk retention.



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