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Evaluation of the Efficacy of Anti-platelet Aggregation Drugs in Patients before Percutaneous Transluminal Angioplasty and Stenting

Author: YuanLin
Tutor: LiuJianMin
School: Second Military Medical University
Course: Surgery
Keywords: Cerebral artery disease Angioplasty antiplatelet agent plateletaggregation inhibitors drug resistance thromboelastograph low responsiveness
CLC: R651.12
Type: Master's thesis
Year: 2013
Downloads: 8
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Abstract


Objective:To detect the platelet inhibition of aspirin and clopidogrel in patients before percutaneous transluminal angioplasty and stenting(PTAS) using a thromboelastograph (TEG) instrument in order to guide the individualized adjustment of anti-platelet aggregation drugs before PTAS.Methods:The clinical data of94patients before PTAS, Venous blood samples were collected at day1,3after anti-platelet aggregation drugs. A TEG instrument was used to detect arachidonic acid (AA)-induced inhibition rate of platelet aggregation and adenosine diphosphate (ADP) receptor-induced inhibition rate of platelet aggregation.Results:The inhibit level of platelet aggregation of aspirin and clopidogrel were both higher at3d than1d [group A:AA%:(82.24±22.25)%vs (87.26±19.82)%, P<0.05; ADP%:(49.62±25.44)%vs (57.02±23.97)%, P<0.05; group C:AA%:(88.88±14.66)%vs (95.06±8.05)%, P<0.05; ADP%:(36.17±22.71)%vs (47.76±24.95)%, P<0.05]. But in the group B and D, there were no significant different in the inhibit level of platelet aggregation of aspirin and clopidogrel at3d than1d [group B:ADP%:(44.98±28.64) vs (50.95±30.89)%, P>0.05; group D:ADP%:(45.48±30.73)%vs (48.93±30.35)%, P>0.05]. We also found that compared with the100mg aspirin group, neither at1d or3d, the300mg asprin group don’t show higher inhibit level of platelet aggregation (P>0.05). No patients have bleeding evevts at3d and perioperative period.Conclusion:Using TEG instrument to detect the inhibition rate of platelet aggregation in patients before PTAS is beneficial to guide the development of therapeutic scheme for individualized anti-platelet aggregation in clinical practice. The inhibitory effect of platelet aggregation of aspirin before PTAS is stable in1d and that of clopidogrel over3d. The patients show differential responses to aspirin and clopidogrel therapy.

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Brain > Cerebrovascular surgery
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