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氯吡格雷抵抗及其对急性冠脉综合征临床结局的影响。

Clopidogrel resistance and its effect on clinical outcomes in acute coronary syndrome.

机构信息

Department of Cardiology, Army Hospital Research and Referral, Delhi Cantonment, New Delhi, 110010, India.

Department of Cardiology, Army Hospital Research and Referral, Delhi Cantonment, New Delhi, 110010, India.

出版信息

Indian Heart J. 2024 Jul-Aug;76(4):268-270. doi: 10.1016/j.ihj.2024.07.003. Epub 2024 Jul 14.

DOI:10.1016/j.ihj.2024.07.003
PMID:39009080
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11451421/
Abstract

AIM

The genetic polymorphism of CYP2C19 influences clopidogrel metabolism and resistance. Aim was to assess the association between CYP2C19 loss of function variation, clopidogrel resistance based on platelet reactivity units and clinical outcomes.

METHODS

A total of 668 patients of Acute Coronary Sundrome (ACS) who underwent Percutaneous Coronary Intervention (PCI) were subjected to genetic screening and 143 patients undrewent platelet function test to study the association between drug metabolization and its effects based on platelet reactivity unit values.

RESULTS

Clopidogrel resistance with CYP2C 19 loss of function variation was noted in 54.64% of patients. Clinical outcomes, such as target vessel revascularization, target lesion revascularization, in-stent restenosis, and stent thrombosis, were also studied.

CONCLUSION

CYP2C19 loss of function variation is strongly associated with clopidogrel resistance and adverse clinical outcomes.

摘要

目的

CYP2C19 的基因多态性影响氯吡格雷的代谢和耐药性。本研究旨在评估 CYP2C19 功能丧失变异与基于血小板反应单位的氯吡格雷抵抗以及临床结局之间的关系。

方法

共纳入 668 例接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者进行基因筛查，其中 143 例患者进行血小板功能检测，以研究药物代谢及其对血小板反应单位值的影响。

结果

54.64%的患者存在 CYP2C19 功能丧失变异导致的氯吡格雷抵抗。还研究了临床结局，如靶血管血运重建、靶病变血运重建、支架内再狭窄和支架内血栓形成。

结论

CYP2C19 功能丧失变异与氯吡格雷抵抗和不良临床结局密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a6a/11451421/de67ec835ac4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a6a/11451421/de67ec835ac4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a6a/11451421/de67ec835ac4/gr1.jpg

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Individualized or Uniform De-Escalation Strategies for Antiplatelet Therapy in Acute Coronary Syndrome: A Review of Clinical Trials with Platelet Function Testing and Genetic Testing-Based Protocols.个体化或统一的抗血小板治疗降级策略在急性冠状动脉综合征中的应用：基于血小板功能检测和基因检测方案的临床试验综述。
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