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An Observational Study of the Relationship Between Outcome and Platelet Reactivity in Chinese Patients Undergoing PCI Loading with 600 mg Clopidogrel

引用

Cardiovascular Innovations and Applications 2020年第3期16卷 27-35页

作者： Jing-xiu Li Ling Weng Xue-qi Li Yang Li Shu-jun Yan Zhao-yan Song Xue-yanZhang Li Cha Lin Lin Tian-shu Yang Wei-jun Lv Ying-nan Dai Ye-ping Chen De-Jun Xia Xin Li En-ze Jin Department of Cardiology The Fourth Affi liated Hospital of Harbin Medical UniversityHarbin150001 HeilongjiangChina School of Public Health of Harbin Medical University Harbin150001 HeilongjiangChina Internal Medicine Harbin Daoli Traditional Chinese Medicine HospitalHarbin150001 HeilongjiangChina

Objectives:We sought to determine whether high posttreatment platelet reactivity(HPPR)to a 600 mg loading dose of clopidogrel affects outcomes in Chinese patients with acute coronary syndrome(ACS)following percutaneous coronary intervention(PCI)and to investigate whether there is a relationship between the number of platelet reactivity units(PRUs)and the characteristics of the ***:Although impaired platelet response to clopidogrel is a strong predictor of unfavorable outcome after PCI,the impact of HPPR to a 600 mg loading dose of clopidogrel in Chinese patients with ACS undergoing PCI is still ***:We performed observational research on 134 unselected patients with ACS undergoing urgent or planned PCI with a 600 mg loading dose of *** activation was expressed as the PRU value measured by the verifynow ***:Among the 134 patients(mean age 60.62 years[standard deviation 9.13 years],60.4%male),there were 46 patients with HPPR(34.3%)and 88 patients without HPPR(65.7%).At a mean follow-up of 6 months(standard deviation 1 month),the rates of cardiac death,unstable angina,and rehospitalization for target lesion revascularization were higher in the HPPR group(19.6%vs.6.8%,P=0.029).Multivariate analysis identifi ed hemoglobin level and sex as independent predictors of the PRU value(y=456.355−1.736 x 1−31.880 x 2,P<0.05).On receiver operating characteristic curve analysis,PRU values could signifi cantly discriminate between patients with and patients without cardiac death,unstable angina,and rehospitalization for target lesion revascularization(area under the curve 0.758,95%confi dence interval 0.62–0.85,P=0.001,P<0.05).Conclusion:In patients with ACS,HPPR to a 600 mg loading dose of clopidogrel is associated with worse outcomes after *** is some relationship between the PRU value and the hemoglobin level and *** values can predict the prognosis.

关键词： clopidogrel platelet reactivity PCI verifynow assay high on-clopidogrel platelet reactivity

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