[The recovery of the function of hyporesponsive platelets during the antiplatelet therapy in patients with chronic cerebral ischemia].

Aim: To establish the ability of recovery of platelet proagregation status in patients with chronic cerebral ischemia receiving standard medical therapy.

Material And Methods: Thirty patients were studied. Platelets were isolated from peripheral blood by centrifugation. For in vitro platelet stimulation we used ADP, epinephrine and PAF. Platelet aggregation was recorded on aggregometer.

Results And Conclusion: 24 hours after the beginning of standard therapy, the patients had 13 platelet phenotypes related to the functional state of three main receptors (purine receptors P2Y1 and P2Y12, α2-adrenergic receptors, and PAF- receptors. After 9-21 days of treatment (before discharge from the hospital), 15 patients (50%) had platelet phenotypes that did not change, i.e. standard medical therapy did not affect the performance of at least one of the receptor clusters, so the risk for initiation of thrombogenesis still remained. Remaining 15 patients had a phenotype with low platelet reactivity to all three agonists studied - cluster [ADP (↓) epinephrine (↓) PAF (↓)] indicating the achievement of antiplatelet effect. The given phenotype is characterized by summation or potentiation of the effects of agonists - ADP and epinephrine in 6 cases (40%), epinephrine and PAF in 6 (40%), ADP and PAF in 3 (20%), which means that conditions for recovery of functional activity of hyporeactive platelets could be further created.