冠心病合并糖尿病患者经皮冠状动脉介入治疗后氯吡格雷低反应的发生率及危险因素

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Abstract [Abstract] Objective To assess the incidence of low response of Clopidogrel and its risk factors in patients with coronary heart disease and type 2 diabetes treated with percutaneous coronary intervention (PCI). Methods A retrospective case-control study was adopted in this study. 210 patients with coronary heart disease and type 2 diabetes who underwent selective PCI in Beijing Anzhen Hospital Affiliated to Capital Medical University from January to September 2015 were selected. All patients received a loading dose of Clopidogrel 300 mg at least 6 h before PCI. All the patients were taken blood samples before Clopidogrel administration as the baseline and at least 24 h post-medication. ADP induced platelet aggregation was measured by light transmittance aggregometry. Low response of Clopidogrel was defined as the absolute difference of the platelet between baseline and post-medication ≤10%. The patients were divided into the normal group (n=133) and the low-response group (n=77), the incidence of low response of Clopidogrel was calculated, and the correlation between age, gender, smoking, blood pressure, blood lipid, HbA1c and low response of Clopidogrel was analyzed. Results The incidence of low response of Clopidogrel in patients with coronary heart disease and type 2 diabetes after selective PCI was 36.67%. There was no significance in the ADP induced platelet aggregation rates between the normal group and the low-response group at baseline (P > 0.05); the platelet aggregation rates of the two groups on 24 h post-medication were (62.62±9.23)% and (32.71±11.77)% respectively, there was significant difference between two groups (P < 0.01). Multivariate Logistic regression analysis found that high level of HbA1c was an independent risk factor of low response of Clopidogrel (P=0.037, OR=1.241, 95%CI 1.013-1.519). Conclusion High level of HbA1c is an independent risk factor of low response of Clopidogrel in patients with coronary heart disease and type 2 diabetes. Low response of Clopidogrel exists significantly in patients with coronary heart disease and type 2 diabetes, making controlled levels of HbA1c is clinically crucial.

Key words： [Key words] Percutaneous coronary intervention Low response of Clopidogrel HbA1c Diabetes

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ZHAI Guangyao ZHOU Yujie▲. Incidence of low response of Clopidogrel and its risk factors in patients with coronary heart disease and type 2 diabetes treated with percutaneous coronary intervention[J]. 中国医药导报, 2016, 13(3): 13-16.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2016/V13/I3/13

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