Integral Tests of the Hemostasis System in Assessing the Efficiency of Acetylsalicylic Acid in Patients with Ischemic Heart Disease

Abstract

Despite the fact that acetylsalicylic acid (ASA) is the “gold” standard for the prevention of cardiovascular complications in patients with coronary heart disease (CAD), some patients still have risks of atherothrombosis. In the present study, the antithrombotic effect of ASA in patients with CAD was assessed using integral hemostasis tests: the T-TAS system (Total Thrombus-formation Analysis System) and the thrombin generation test (TGT) in platelet-rich plasma (PRP). The study involved 34 patients with stable CAD (11 women, 23 men) and 33 people (15 women, 18 men) in the control group. Evaluation of the activity of thrombus formation by means of the T-TAS system revealed a significant decrease in the area under the curve (AUC10) in the group of CAD patients as compared with the control (135.6 [88.0–222.3] and 260.5 [217.3–301.9], p < 0.05). The TGT analysis in PRP has shown that in CAD patients, there was a decrease in the peak concentration of thrombin (PTh) and the rate of thrombin (VI) formation (100.5 [78.3–127.7] and 125.7 [118.7–161.5], nmol; 7.2 [4.7–11.1] and 14.9 [11.6–18.1], nmol/min, p < 0.01, respectively), and an increase in time parameters of the test. The number of patients with high platelet reactivity detected by T-TAS was higher than those detected by TGT (38.2% (n = 13) and 20.8% (n = 7), respectively). In the group of CAD patients correlation analysis revealed a relationship between an increase in VI with an increase in AUC10 according to T-TAS data (r = 0.37; p = 0.03). Thus, the study, T-TAS and TGT in PRP have shown their effectiveness in assessing the antithrombotic properties of ASA in CAD patients.