Antiplatelet drug activity evaluation in patients of acute coronary syndrome in central india: in the scenario of antiplatelet drug resistance

Background: Antiplatelet drugs are the cornerstone in the management of acute coronary syndrome. Recent studies suggest variability in response to aspirin and clopidogrel. A few patients on preventive therapy with aspirin and/or clopidogrel got recurrent attacks of thromboembolic episodes, further pointing towards an uncertain response. Method: A cross sectional, observational study was conducted in a tertiary care rural hospital in central India. 102 patients with a diagnosis of acute coronary syndrome who were prescribed aspirin and or clopidogrel for at least 7 days as antiplatelet therapy were included in the study. The samples were tested for platelet function by a test which was an adaptation of plateletworks kit. Results: On evaluation, the prevalence of aspirin resistance was 45.09%, of which 21 % were non responders while 24% were semi responders. Clopidogrel resistance was found to be 76.13%, of which 29% were non responders while 47% were semi responders. Conclusion: Our study shows an upsurge in aspirin and clopidogrel resistance. Standard yet less expensive, affordable, specific and sensitive platelet function assays are needed to see the antiplatelet aggregation activity to assure the drugs activity to the fullest.