Haji Aghajani Mohammad, Kobarfard Farzad, Shojaei Seyed Pouzhia, Ahmadpour Froozan, Safi Olia, Kazemina Neda, Zarepishe Naeime, Sistanizad Mohammad
Department of Cardiology, Emam Hossein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medical Chemistry, Faculty of pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2018 Summer;17(3):1099-1104.
The aim of current study was evaluating the frequency of clopidogrel resistance and its impact on clinical outcome of patients in Iranian patients. Patients undergoing percutaneous coronary intervention in Imam Hussein Medical center, Tehran, Iran, who received standard dosage of clopidogrel (Plavix®, Sanofi, France, 600 mg loading dose and 75 mg/day afterward) were recruited. Platelet aggregation was measured using light transmission aggregometer. The patients were categorized as responder (platelet aggregation less than 43%) and non-responder (platelet aggregation more than 43%). All patients were evaluated for major adverse cardio vascular events one month and 3 years after the angioplasty based on MACE criteria by phone contact. One hundred and five patients with average age of 60.30 ± 12.2 years entered the study of whom 26 (24.76%) did not respond to clopidogrel. None of patients experienced cardiac events one month after PCI. Three years after PCI, data were collected from 55 (69.62%) and 10 (38.46%) subjects in responder and non-responder groups, respectively. MACE criteria was positive in 4 patients, 3 (5.45%) in responder and 1 (10%) in non-responder group ( = 0.28). We did not find any significant differences between clopidogrel resistance and past medical history. In drug history 1 (1.26%) and 4 (15.38%) patients received omeprazole with clopidogrel in responder and none-responder group, respectively ( = 0.003). This study showed 24.76% resistance to clopidogrel in Iranian population but, we did not find any correlation between clopidogrel resistance and cardiac events in follow up maybe due to study limitations particularly missed follow-up in non-responder patients.
本研究的目的是评估伊朗患者中氯吡格雷抵抗的发生率及其对患者临床结局的影响。招募了在伊朗德黑兰伊玛目侯赛因医疗中心接受经皮冠状动脉介入治疗且接受标准剂量氯吡格雷（波立维®，赛诺菲，法国，负荷剂量600毫克，之后每日75毫克）的患者。使用光透射聚集仪测量血小板聚集情况。患者被分为反应者（血小板聚集小于43%）和无反应者（血小板聚集大于43%）。根据MACE标准，通过电话联系对所有患者在血管成形术后1个月和3年时的主要不良心血管事件进行评估。105名平均年龄为60.30±12.2岁的患者进入研究，其中26名（24.76%）对氯吡格雷无反应。PCI术后1个月无患者发生心脏事件。PCI术后3年，分别从反应者组和无反应者组的55名（69.62%）和10名（38.46%）受试者中收集数据。4名患者MACE标准呈阳性，反应者组3名（5.45%）无反应者组1名（10%）（P= =0.28）。我们未发现氯吡格雷抵抗与既往病史之间存在任何显著差异｡在用药史方面，反应者组和无反应者组分别有1名（1.26%）和4名（15.38%）患者同时接受奥美拉唑和氯吡格雷治疗（P= =0.003)。本研究显示伊朗人群中氯吡格雷抵抗率为24.76%，但在随访中未发现氯吡格雷抵抗与心脏事件之间存在任何相关性｡这可能归因于研究局限性｡特别是无反应者组患者随访缺失｡
