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
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
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.