To compare the newer inductor of platelet aggregation cationic propyl gallate (CPG) with adenosine diphosphate (ADP) for the examination of aspirin (ASA) effectivity with optical aggregometry. In total,116 patients were prospectively enrolled with a stable cardiovascular disease, taking ASA 100 mg/day for >or=1 month. The control group consisted of 62 healthy volunteers. A platelet aggregation was investigated by optical aggregometry (aggregometer LASER 4x; BIO ART, Sint-Katelijne-Waver, Belgium). CPG and ADP were added as aggregating agents. The measured parameters were CPG-slope (%/min) and ADP max (%). Using the CPG-slope values from the control group, the CPG-slope cut-off value was determined to define a laboratory ASA-noneffectively treated patient. The values from control group followed a normal distribution (Shapiro-Wilk test). We calculated the cut-off value using the 1-tailed 95% confidence interval. The CPG-slope cut-off value was 79 %/min for an ASA-effectively treated patient. We marked the patients as laboratory ASA-noneffective treated when the CPG-slope was >79%/min. In the same way we defined the cut-off value for ADP-max. We identified the aspirin treatment as ineffective when the value of ADP-max was >62%. The values of CPG-slope and ADP-max were in close correlation in the group of patients treated with aspirin with a highly significant correlation index (r=0.671, P<0.001). By CPG-induced optical aggregation, 33,6% were ASA-noneffectively treated patients. When using both inductors, the proportion of ASA-noneffectively treated patients was 25%. Using both tests, 72.4% of patients were equally divided. ASA-noneffectively treated patients were commonly more obese (46.2%), had hypertension (94.9%) and hypercholesterolemia (73.7%), and were less commonly treated with statins (30.8%) than the aspirin effectively treated patients (42%, 88.2%, 59.2%, and 42.1%, respectively). The detected differences were not statistically significant. Cationic propyl gallate is an optimal inductor for optical aggregometry to monitor laboratory effectiveness of aspirin therapy in routine clinical pratice. The determined high prevalence of laboratory aspirin ineffectiveness highlights the clinical importance of the problem. This study brings attention to the importance of controlling cardiovascular risk factors.

• MeSH
• adenosindifosfát farmakologie   MeSH
• Aspirin terapeutické užití   MeSH
• faktor aktivující destičky účinky léků   MeSH
• financování organizované MeSH
• inhibitory agregace trombocytů terapeutické užití   MeSH
• kardiovaskulární nemoci farmakoterapie   krev   prevence a kontrola   MeSH
• kationty farmakologie   MeSH
• léková rezistence MeSH
• lidé středního věku MeSH
• lidé MeSH
• propylgalan farmakologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• studie případů a kontrol MeSH
• techniky in vitro MeSH
• trombocytový glykoproteinový komplex IIb-IIIa metabolismus   MeSH
• vyšetření funkce trombocytů metody   normy   přístrojové vybavení   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• klinické zkoušky kontrolované MeSH
• srovnávací studie MeSH

LDL-apheresis is a method of extracorporeal elimination of serum LDL-cholesterol used for treating patients with severe hyperlipidemia resistant to diet and pharmacotherapy. A practically applicable marker that may possibly be used to ascertain the efficacy of this treatment in lowering the activity of atherosclerosis are still to be found and remains an unresolved problem. Activity of primary hemostasis plays an important role in the process of developing atherosclerotic complications. This fact led us to hypothesize that the investigation of primary hemostatic activity might be a useful marker for monitoring LDL-apheresis efficacy. The aim of this work was to verify this hypothesis. METHODS AND PATIENTS: Commercial analyzer Dade Behring PFA-100, Germany (PFA, platelet function analysis) was used for all investigations. This analyzer enables quantitative measurement of platelet-mediated hemostasis in uncoagulated (citrated) blood. The method simulates platelet activation by mechanical stress (shear stress), and also simulates contact of platelets with collagen. A total of nine long-term treated patients with familial hypercholesterolemia were included in the study group (4 females and 5 males). Ages ranged from 17 to 59 years (average 46.4, median 55). Two patients had homozygous hypercholesterolemia. Eighteen sample pairs were examined using collagen/epinephrine (COL/EPI) membrane and 17 pairs were examined using collagen/ADP (COL/ADP) membrane, the total number of samples amounted to 70. RESULTS: Closure time (CT) values were prolonged after separation in all cases but CT prolongation was not statistically significant (p < 0.14). No differences between homozygous and heterozygous patients were found (p < 0.05). CONCLUSION: Investigation of primary hemostasis using PFA-100 analyzer is not a suitable marker and should not be used to determine the optimal intensity of individual LDL-apheresis procedures.

• MeSH
• aktivace trombocytů MeSH
• dospělí MeSH
• familiární kombinovaná hyperlipidemie terapie   MeSH
• financování organizované MeSH
• hemostáza MeSH
• hypercholesterolemie terapie   MeSH
• hyperlipidemie terapie   MeSH
• LDL-cholesterol MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• separace krevních složek metody   MeSH
• vyšetření funkce trombocytů normy   přístrojové vybavení   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• hodnotící studie MeSH