Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
Angiology. 2012 Jan;63(1):62-6. doi: 10.1177/0003319711406432. Epub 2011 May 20.
We evaluated the relationship between plasma inflammation markers and clopidogrel resistance in patients after stent implantation. The plasma levels of C-reactive protein (CRP), P-selectin, platelet soluble CD40 ligand (sCD40L), interleukin 6 (IL-6) and platelet aggregation were measured in 352 patients undergoing percutaneous coronary intervention (PCI) at baseline and after 6 months. The plasma levels of CRP, P-selectin, sCD40L, IL-6 was higher in 65 (18.5%) patients with clopidogrel resistance than in those with normal responsiveness at 6 months after PCI. There was a significant positive correlation between soluble CD40L levels and platelet aggregation (r = .28, P < .05). Diabetes (DM) and sCD40L level were independent predictors for unresponsiveness after stent implantation according to stepwise multivariate analyses. The hazard ratio (HR) for sCD40L level was 3.02 (95% CI = 1.28 to 3.25; P = .036) and for DM 2.53 (95% CI = 1.28 to 6.55, P = .03). We conclude that sCD40L and DM may influence clopidogrel resistance.
我们评估了支架植入术后患者的血浆炎症标志物与氯吡格雷抵抗之间的关系。在 352 例行经皮冠状动脉介入治疗（PCI）的患者中，我们在基线和 6 个月时测量了 C 反应蛋白（CRP）、P 选择素、血小板可溶性 CD40 配体（sCD40L）、白细胞介素 6（IL-6）和血小板聚集的血浆水平。在 PCI 后 6 个月时，65 例（18.5%）氯吡格雷抵抗患者的 CRP、P 选择素、sCD40L、IL-6 血浆水平高于正常反应者。可溶性 CD40L 水平与血小板聚集呈显著正相关（r =.28，P <.05）。根据逐步多变量分析，糖尿病（DM）和 sCD40L 水平是支架植入后无反应的独立预测因素。sCD40L 水平的危险比（HR）为 3.02（95%可信区间为 1.28 至 3.25；P =.036），DM 为 2.53（95%可信区间为 1.28 至 6.55，P =.03）。我们得出结论，sCD40L 和 DM 可能影响氯吡格雷抵抗。
