Institute of Hematological Research, 159431Shaanxi Provincial People's Hospital, Xi'an, China.
Central laboratory, S159431haanxi Provincial People's Hospital, Xi'an, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221083674. doi: 10.1177/10760296221083674.
Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (10/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (10/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.
由于阿司匹林和氯吡格雷是经皮冠状动脉介入治疗（PCI）后治疗急性心肌梗死的常用药物，因此探索其耐药的潜在危险因素非常重要。对 219 例 PCI 患者标准治疗 24 h 后，用花生四烯酸（AA，PAg-AA%）和二磷酸腺苷（ADP，PAg-ADP%）测定血小板聚集率。并获取患者的病史和实验室数据（PCI 前）。我们发现 101 例（46.12%）患者对阿司匹林耐药，PAg-ADP%是阿司匹林耐药的最显著危险因素。在 219 例患者中，氯吡格雷抵抗患者 157 例。氯吡格雷抵抗组患者携带更多的 CYP2C19*3 或 *2，这与该组（69.11%，47/68）的氯吡格雷抵抗率高于对照组（64.29%，36/56）相关。血小板计数（10/L）和血红蛋白（g/L）是氯吡格雷抵抗的显著危险因素。在 219 例患者中，有 98 例出现双重抗血小板药物抵抗，其中血小板计数（10/L）和单核细胞计数（g/L）是危险因素。发现阿司匹林抵抗通常伴有氯吡格雷抵抗。
