Red cell distribution width, other hematological parameters and atherogenic index of plasma in patients with clopidogrel and aspirin resistance

Authors : Yasemin USTUNDAG BUDAK, Kagan HUYSAL, Sanem KARADAG GECGEL, Hasan ARİ, Mehmet MELEK, Senol YAVUZ, Sencer CAMCİ, Alper KARAKUS, İbrahim AKTAS, Selma ARİ

Pages : 200-205

Doi:10.18621/eurj.2016.5000200132

View : 22 | Download : 9

Publication Date : 2016-11-04

Article Type : Research Paper

Abstract :Objective. Chronic inflammation might favour platelet hyperactivity, which leads to inter-individual variability in antiplatelet resistance. The aim of this study was to test the hypothesis that there is a relationship between some hematological parameters reported as measures of systemic inflammation, the atherogenic index of plasma insert ignore into journalissuearticles values(AIP);, and antiplatelet responsiveness. Methods. This retrospective study included patients receiving aspirin insert ignore into journalissuearticles values(100 mg); and clopidogrel insert ignore into journalissuearticles values(75 mg); daily before and after stenting. Platelet inhibition was assessed using the VerifyNow P2Y12 point-of-care test. Resistance to antiplatelet therapy was defined as P2Y12 reactivity exceeding 240 units insert ignore into journalissuearticles values(for clopidogrel); or aspirin reaction units exceeding 550 units insert ignore into journalissuearticles values(for aspirin);. The AIP was calculated as the logarithm of triglyceride/high density lipoprotein cholesterol. The white blood cell insert ignore into journalissuearticles values(WBC);, platelet insert ignore into journalissuearticles values(P);, neutrophil insert ignore into journalissuearticles values(N);, and lymphocyte insert ignore into journalissuearticles values(L); counts, red cell distribution width insert ignore into journalissuearticles values(RDW);, hemoglobin insert ignore into journalissuearticles values(Hb);, plateletcrit, mean platelet volume insert ignore into journalissuearticles values(MPV);, platelet distribution width, and N/L and P/L ratios were evaluated. Results. Of 232 patients insert ignore into journalissuearticles values(73% male; median age, 63 years; range, 38-87 years);, 52 insert ignore into journalissuearticles values(22%); were aspirin resistant and 82 insert ignore into journalissuearticles values(35%); were clopidogrel resistant; 7.7% were both aspirin and clopidogrel resistant. Median RDW levels were significantly higher insert ignore into journalissuearticles values(14.4% [interquartile range insert ignore into journalissuearticles values(IQR); 3] vs. 13.9% [IQR 1.3]; p =0.01); and Hb levels significantly lower insert ignore into journalissuearticles values(12.0±1.6 g/dL vs. 13.2±1.7 g/dL; p <0.001); in the clopidogrel-resistant patients than in the clopidogrel responders. WBC, AIP, MPV, N/L, and P/L ratios were not statistically significant insert ignore into journalissuearticles values( p >0.05);. Multivariate logistic regression showed that Hb insert ignore into journalissuearticles values(odds ratio [OR]=0.73; 95% confidence interval [CI], 0.60-0.88; p =0.001); and RDW insert ignore into journalissuearticles values(OR=1.26; 95% CI, 1.02-1.55; p =0.02); were independent predictors of clopidogrel resistance. Conclusion. Both RDW and Hb were independent variables associated with clopidogrel resistance, but antiplatelet resistance cannot be predicted based on other hematological parameters or AIP. 
Keywords : Red cell distribution width, hematological parameters, atherogenic index of plasma, systemic inflamation, clopidogrel resistance