Evaluation of laboratory effectiveness of clopidogrel after elective endovascular procedures in patients with the history of the new coronavirus infection (COVID-19)

Aim. To evaluate the impact of antiplatelet agent clopidogrel on the aggregation platelet activity in patients with the history of the new coronavirus infection (COVID-19).

Materials and methods. The impact of clopidogrel on platelet aggregation was studied in 47 patients with coronary heart disease after coronary artery stenting. The patients were assigned to 2 groups: group 1 comprised the patients who were not affected by COVID-19 (n=31), while group 2 comprised the patients who had COVID-19 (n=26) 3 months – 1 year (mean, 5±1.3 months) before being included in the study.

Results. The use of clopidogrel contributed to platelet aggregation decrease to the target levels in both groups. Platelet aggregation, assessed by Born technique, was 22.9 and 22.7% in groups 1 and 2, respectively. Platelet aggregation, assessed by the technique of optical transmission agregometry (system VerifyNow, P2Y12), was 152.3 and 147.2 PRU in groups 1 and 2, respectively. The data obtained in each group were not significantly different and attested to high laboratory effectiveness of clopidogrel. Besides, we did not find reliable differences in the levels of inflammation marker: C-reactive protein, fibrinogen, leucocytes, as well as of D-dimer, in the studied groups.

Conclusion. In 3 months – 1 year after COVID-19, the laboratory effectiveness of Clopidogrel used in standard dosage of 75 mg/day is compliant with target indices and does not differ from the effectiveness in patients with no history of COVID-19. At this stage of our study, the obtained results do not imply the necessity of changing the protocol of double antiplatelet therapy after coronary artery stenting in stable patients with coronary artery disease, who suffered COVID-19 three months – 1 year before being included in the study, and show the necessity of further investigations.