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Aim. To study the features of the state of hemostasis and platelet enzymes activity in acetylsalicylic acid (ASA) sensitive and resistant patients with acute coronary syndrome (ACS).Material and methods. The study included 53 patients (25 men and 28 women) with ACS during the first 24 hours and after 10 days. The control group included 50 healthy volunteers. Before treatment the patients were tested on the sensitivity and resistance to ASA. The indicators of vascularplatelet and plasma hemostasis were evaluated as well as the NAD(P)- dependent dehydrogenases activity in platelets was assessed by the bioluminescent method in the first day of ACS before antiplatelet therapy and on day 10.Results. Increase in spontaneous [1.72 U (1.28-2.72 U) and 1.60 U (1.49-2.78 U), respectively] and ADP-induced [24.4% (21.1-29.8%) and 19.2% (16.1-22.9%), respectively] platelet aggregation, von Willebrand factor activity [159.0% (108.0-190.0%) and 155.0% (149.0-185.1%), respectively] was found in ASA-resistant patients with ACS in 1 and 10 day. Besides the ASA-resistant patients with ACS had very low pentose phosphate cycle and lactate dehydrogenase aerobic activity. They also demonstrated, compared with ASA-sensitive patients, higher intensity of aerobic respiration and the level of NADP-dependent substrate exchange between the tricarboxylic acid cycle and reactions of amino acid metabolism.Conclusion. Despite the dual antiplatelet therapy with ASA and clopidogrel, risk of thrombotic events is saved in ASA resistant patients with ACS. The metabolic changes in platelet influence their aggregation activity and cause an inadequate response to the antiplatelet therapy in ACS patients.

Aim. To study the specifics of relation between hemostasis parameters and functional activity of neutrophil granulocytes in sensitive and resistant to acetylsalicylic acid (ASA) patients with acute coronary syndrome.Material and methods. Totally 53 patients included during the first 24 hours of ACS. Controls consisted of 50 relatively healthy individuals. All patients before the treatment and revascularization were assessed for the resistance to ASA, and selected into groups of sensitive (AS) and resistant (AR). Sensitivity test was done in vitro. In all participants the coagulation and platelet clotting systems were studied. With the luminescent method the neutrophil activity was assessed. Results. In AR with ACS there was decrease of platelets in blood, decreased level of ADP- (ADP 5 mcM) and adrenalin-induced aggregation, increases the level of ADP-induced platelets aggregation (PA) with ADP 0,1 mcM, and von Willebrand factor level. In the ASA sensitive patients there was a decrease of adrenalin induced aggregation.There were no specifics of coagulation hemostasis according to ASA sensitivity. Chemiluminiscence (CL) of neutrophils in ACS has a maximized out time. In AR there was decrease of activation. In AS functional activity of neutrophils more significantly correlates with the parameters of clotting, but in AR — with fibrinolytic and anticoagulation parameters.Conclusion. In ACS patients depending on ASA sensitivity, there are character specifics of platelet clotting: increase of ADP-induced aggregation in AR, decrease of platelet amount and the level of von Willebrand factor. In ACS patients there is a decreased velocity of "respiratory boost" in neutrophils. In AR there is more prominent dysbalance of coagulation hemostasis and "respiratory boost" of neutrophils, with the decrease of neutrophil reactivity related to clotting activity and appearance of relations with the parameters of fibrinolytic and anticoagulation activity.

Objective: to study the features of the chemiluminescent state and the activity of NAD (P) -depen- dent dehydrogenases in neutrophilic granulocytes of blood in patients with different sensitivity to acetylsalicylic acid (ACA) in acute coronary syndrome (ACS).Materials and methods: The study included 53 patients with ACS. Evaluation of resistance or sensitivity to ASA was performed in vitro by incubating platelet-rich plasma with adenosine diphosphate and ASA to determine the level of aggregation. The state of respiratory explosion of neutrophils was investigated by the method of chemiluminescence. The activity of enzymes in neutrophils was studied by the bioluminescent method.Results of the study: In patients with ACS-resistant ACS, the rate of synthesis of primary and secondary active forms of oxygen was reduced, and the index of luminol-dependent activation of neutrophils was reduced. The intensity of substrate stimulation of glycolysis and oxidation of glucose by the pentose phosphate pathway is increased.Conclusion: With resistance to ASA in patients with ACS, there are abnormalities in the metabolism and functional activity of neutrophils, which is of interest in studying the intercellular relationships of thrombus formation.