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Research on Clopidogrel Resistance in Coronary Heart Disease Patients Underwent Percutaneous Coronary Interventions

Author: RenKe
Tutor: SongYaoMing
School: Third Military Medical University
Course: Internal Medicine
Keywords: Coronary heart disease Clopidogrel Clopidogrel resistance Coronary intervention Platelet activation Platelet activation markers Antiplatelet therapy MACE Event
CLC: R541.4
Type: Master's thesis
Year: 2011
Downloads: 55
Quote: 0
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Abstract


Purpose by observing coronary heart disease in patients with clinical routine laboratory tests , coronary intervention (percutaneous coronary interventions, PCI) and PCI postoperative follow-up , etc. , as well as PCI preoperative , postoperative platelet aggregation rate (maximum platelet aggregation rate, MPAR) and platelet activation markers CD62P, PAC -1 changes , investigate the incidence of coronary heart disease patients after PCI clopidogrel resistance and its influencing factors . Methods Third Military Medical University Cardiology, Xinqiao Hospital from September 2009 to July 2010 , 112 underwent PCI in the treatment of patients with coronary heart disease , I preoperative oral clopidogrel 300mg loading dose therapy after surgery to 75mg / d continuous treatment . Their medication before PCI after 24h and 5d 5μmol / L adenosine diphosphate (adenosine diphosphate, ADP) - induced MPAR CD62P and PAC-1 indicators measured by flow cytometry using whole blood . Defined as clopidogrel resistance is divided into the the clopidogrel resistance group ( referred to as the resistance group ) after PCI 5d platelet aggregation inhibition rate ≤ 10% and on the the clopidogrel response of normal group ( normal group) , the two groups were compared bed cardiovascular events (major adverse cardiac event, MACE) occurred in six month follow-up clinical characteristics , routine laboratory tests results , the PCI treatment of MARP , CD62P, PAC -1 indicators and after PCI . Resistance group and the normal group , the basic clinical data , results of routine laboratory tests , and no significant difference between PCI treatment of 46 cases ( 41.07% ) , the normal reaction to clopidogrel ; PCI 24h after clopidogrel resistance patients patients , 66 cases ( 58.93% ) ; PCI of 5d occur after clopidogrel resistance in patients with 27 cases ( 24.11% ) of clopidogrel response in patients with normal and 85 cases ( 75.89% ) , clopidogrel resistance was 24.11% ; contrast after PCI before medication resistant group of patients of CD62P , PAC -1 levels were higher than normal group ( P lt; 0.05 ) ; PCI after 6 months follow-up , the resistance group, the high incidence of MACE events in normal group (P lt; 0.05). Conclusion CD62P and PAC-1 is an important indicator of platelet activation , clopidogrel resistance phenomenon and platelet activation state is closely related ; PCI preoperative level of platelet activation in patients of coronary heart disease is one of the factors of the independent effects of clopidogrel resistance ; PCI surgery MACE events after clopidogrel resistance phenomenon is closely related to .

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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