冠心病患者冠状动脉介入治疗术后氯吡格雷抵抗的发生率及影响因素

目的 探讨冠心病患者冠状动脉介入治疗术(percutaneous coronary interventions,PCI)后氯吡格雷抵抗发生率及其影响因素.方法 选取新桥医院心内科2009年9月至2010年 7月期间112例行PCI术治疗的冠心病患者,术前予氯吡格雷300 mg负荷剂量治疗,术后予75 mg/d持续治疗....

Incidence and influential factors of clopidogrel resistance in coronary heart disease patients who received percutaneous coronary interventions

Objective To discuss the incidence and influential factors of clopidogrel resistance in coronary heart disease patients who received percutaneous coronary interventions(PCI).Methods One hundred and twelve coronary heart disease patients who underwent PCI in Xinqiao Hospital,Chongqing,China,from Sep.2009 to Jul.2010 were selected.Clopidogrel of 300 mg loading dose and 75 mg/d ongoing dose was administered before and after PCI.The 5 μmol/L adenosine diphosphate(ADP)-induced maximum platelet aggregation rate(MPAR),CD62P,and PAC-1 were tested before administration as well as 24 h and 5 d after PCI.The patients were divided into a clopidogrel-resistant group(platelet aggregation rate ≤10%) and a normal response group.The basic clinical data,related routine examination results,MARP,CD62P,PAC-1,and following-up information of the two groups were compared.Results The basic clinical data,related routine examination results,and PCI basic characteristics of the clopidogrel-resistant group and normal response group showed no obvious difference.Forty-six patients(41.07%) and twenty-seven patients(24.11%) suffered clopidogrel resistance 24 h and 5 d after PCI,respectively.CD62P and PAC-1 levels of the former group were higher than those of the latter one before administration and after PCI(P<0.05).The six-month following-up showed that the cardiovascular event incidence of the former group was higher than that of the latter one(P<0.01).Conclusion The platelet activation level before PCI is an independent influential factor for clopidogrel resistance incidence.