Perbedaan respon antara pemakai Clopidogrel dengan Asam Asetiliasilat terhadap Agregasi Trombosit in Vitro

Tahun 2006 Volume 41 Nomor 3
Oleh : Lisyani B Suromo

latar belakang : Obat clopidogrel dan sam asetisalisilat (ASA) banyak digunakan untuk mencegah komplikasi aterosklerosis . Banyak penelitian klinik telah dilaporkan tentang perbedaan efek antara clopidogrel dengan ASA (a.l.clopidogrel versus aspirin in patient at risk of aschaemic event ), namun perbedaan respons agregasi trombosit antara kedua obat tersebut secara laboratorik belum pernah dilakuakn . Tujuan penelitian ini ialah untuk meniali perbedaan rerata % agregasi maksimal dan respons hipoagresi in vitro antara kelompok pemakai clopidogrel denagn ASA pada penderita penyakit yang berhubungan dengan aterosklerosis.

Metode : Studi belah lintang dilakukan terhadap 2 kelompok : pemakai clopidogrel (dosis ½ – 1 tablet a 75 mg/hari )dan ASA (dosis 80 -100 mg/hari). Pengambialn sampel secara konsekutif , besar sampel 30 /kelompok .Kriteria Inklusi :pria dan wanita >= 40 tahun ,menderita /berisiko menderita penyakit kardiovaskuler , rawat jalan , memakai clopidogrel atau ASA selama >= 1 bulan s/d 1 tahun , aktivitas fisik dan psikis normal ,tidak minum obat lain / makanan / minuman yang mempengaruhi fungsi agregasi trombosit .Spesimen whole blood doperiksa menggunakan tes agregasi trombosit (TAT) dengan prinsip tur bidimetri cara Born (PACK 4) .Adenosin difosfat 10 uM dipakai sebagai Induktor.Perbedaan rerata % agregasi maksimal dan respons hipoagregasi diuji dengan test t independent dan pearson Chi-Square.

Hasil : Agregasi maksimal pada kelompok clopidogrel : 49,3± 13.09 max % (p=0,000 ;IK; 7.982, 24.378). Respon Hipoagregasi dijumpai pada 25 subyek dari kelompok clopidogrel dan 19 subyek dari kelompok ASA(p=0,080)

Simpulan :Respon agergasi trombosit in vitro antara pemakai clopidogrel dengan ASA menunjukkan perbedaan bermakna untuk rerata % agregasi maksimal dan tidak bermakna untuk respon hipoagregasi.

The difference of platelat agregation in vitro between clopidogrell and acetylsallicylic acid consumers

Background :Clopidogrel and acetysalicylic acid (asa) are commonly used to prevent atheroscleroric complications Clinical trilas had been reported in comparing the effects of clopidogrel and ASA (e.g. clopidogrel versus aspirin in patient at risk of ischaemic events )>Study about the different of platelat aggregation in vitro between those drugs have not yet been conducted. The aim of this study was to evaluated the difference of platelet aggregation in vitro beetween clopidogrel and ASA consumers at risk of atherosclerosis.

Methods : A cross sectional study had been conducted with 2 groups : clopidogrel (dosage :½ – 1tablet á 75 mg/day ) and ASA (dosage 80 -100 mg/day) consumers.Thirty sample / group were taken consequtively.iclusion criterias : men and women ,age >=40 years old,suffered from or had risk of cardiovasculer disease, ambualory patients, taking clopidogrel or ASA >=1 month – 1 years , normal pyhcisal and psycological activities , not consuming : other drugs, food, beverages which would influence the platelet function . Whole blood specimen were examined using the platelet aggregation test of Born method (PACK 4) .Ten uM of adenosinee disphospahate was used as an inductor. The mean value of % maximal aggregation and aggregation responses were evaluated using t – independent and pearson Chi- Square tests.

Result : Maximal aggregation of clopidogrel consumers :ASA andIK were 49,3 ± 18,22 max % ; 65,5± 3,09 max%

(p=0,000 ;IK; 7.982, 24.378) respectively.Hipoaggregation responses were found in 25 clopidogrel and 19 ASA consumers (p=0,080)

Conclusions : There is a different in vitro response of trombocytes maximal aggregation between clopidogrel and ASA users, nut not in hypoaggregation response.