The aim of the study was to evaluate the relationship with clopidogrel (ADPtest) and aspirin (ASPItest) response measured by Multiplate (Dynabyte, Munich, Germany) and risk of ischemic or bleeding events in patients with acute coronary syndrome (ACS) within 30-days period. 405 patients were enrolled into this prospective, observational study. Group 1 included 350 patients without events, group 2- 36 patients with ischemic events (stent thrombosis, recurrence of myocardial infarction, peri-infarction angina), group 3 – 19 patients with bleeding. Low residual platelet reactivity (LRPR) on aspirin was defined in ASPItest lower 10U, LRPR on clopidogrel in ADPtest lower 19U, high residual platelet reactivity (HRPR) on aspirin was defined in ASPItest higher 30U, HRPR on clopidogrel in ADPtest higher 50U. The ASPItest in group 1 was 19 [12; 29]U, in group 2 – 24 [12; 42]U, group 3 – 12 [4; 24]U, p=0.034. The ADPtest in group 1 was 29 [20; 45]U, in group 2 – 47.5 [26; 59]U, group 3 – 20 [14; 41]U, p=0.003. The risk of bleeding was higher in the group of patients with LRPR on aspirin, risk ratio (RR) (2.6; 95% CI 1.6–4.4; P = 0.0003). The risk of ischemic events was higher in the group of patients with HRPR on aspirin, RR (1.95; 95% CI 1.3–2.9; P = 0.0007). The risk of bleeding was higher in the group of patients with LRPR on clopidogrel – RR (2.3; 95% CI 1.4–3.8; P = 0.0016). The risk of ischemic events was higher in the group of patients with HRPR on clopidogrel RR (2.1; 95% CI 1.4–3.2; P = 0.0004). The results of this study show that impaired platelet response to clopidogrel and aspirin results in increased risk ischemic events, increased response to clopidogrel or aspirin is related to bleeding events within 30 days after ACS.

Tatyana Pronko has completed her PHD at the age of 28 years from Grodno State Medical University, Belarus. She is Head of the Department of Propaedeutics of Internal Diseases of Grodno State Medical University since 2012. She has over 250 publications that have been cited over 170 times, and her publication h-index is 5. She is member of European Cardiology Society.