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使用VerifyNow检测对接受经皮冠状动脉介入治疗患者的双重抗血小板治疗耐药性的早期检测及相关因素。

Early detection of resistance to dual antiplatelet therapy in patients who have undergone percutaneous coronary intervention using the VerifyNow test and associated factors.

作者信息

Tran Song Giang, Tran Thi Kieu My, Nguyen Tan Sang, Vu Minh Phuong

机构信息

Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11519, Vietnam.

Department of Hematology, Hanoi Medical University, Hanoi 11521, Vietnam.

出版信息

Med Int (Lond). 2024 Jul 18;4(6):56. doi: 10.3892/mi.2024.180. eCollection 2024 Nov-Dec.

Abstract

Resistance to dual antiplatelet therapy (DAPT), including aspirin and clopidogrel, in patients who have undergone percutaneous coronary intervention (PCI) leads to the inability to prevent thrombotic complications. The present study aimed to evaluate early resistance to aspirin and clopidogrel in patients following PCI using the VerifyNow test and associated factors. A total of 50 patients diagnosed with acute coronary syndromes (ACS) who underwent emergency PCI and received DAPT were recruited in the present study. The detection of resistance to aspirin and clopidogrel was performed using the VerifyNow system. Resistance to aspirin was determined with VerifyNow Aspirin >550 aspirin reaction units (ARU). Resistance to clopidogrel was determined with VerifyNow P2Y12 >208 P2Y12 reaction units (PRU). The resistance rate to aspirin was 14%, while the resistance rate to clopidogrel was higher, at 34%. There were 2 patients with resistance to aspirin and clopidogrel (4%). Univariable logistic regression analysis revealed that diabetes, the use of β-blockers, and low levels of hemoglobin and hematocrit were associated with resistance to clopidogrel. Following multivariable logistic regression analysis, only the use of β-blockers was truly associated with resistance to clopidogrel. On the whole, the results of the present study may also prove to be helpful in the selection of therapeutic drugs for patients undergoing PCI and who are diagnosed with ACS.

摘要

接受经皮冠状动脉介入治疗(PCI)的患者对包括阿司匹林和氯吡格雷在内的双重抗血小板治疗(DAPT)产生耐药性会导致无法预防血栓形成并发症。本研究旨在使用VerifyNow检测法及相关因素评估PCI术后患者对阿司匹林和氯吡格雷的早期耐药性。本研究共纳入50例诊断为急性冠状动脉综合征(ACS)并接受急诊PCI且接受DAPT的患者。使用VerifyNow系统检测对阿司匹林和氯吡格雷的耐药性。当VerifyNow阿司匹林检测结果>550阿司匹林反应单位(ARU)时判定为对阿司匹林耐药。当VerifyNow P2Y12检测结果>208 P2Y12反应单位(PRU)时判定为对氯吡格雷耐药。对阿司匹林的耐药率为14%,而对氯吡格雷的耐药率更高,为34%。有2例患者对阿司匹林和氯吡格雷均耐药(4%)。单因素逻辑回归分析显示,糖尿病、使用β受体阻滞剂以及血红蛋白和血细胞比容水平低与氯吡格雷耐药相关。经过多因素逻辑回归分析,只有使用β受体阻滞剂与氯吡格雷耐药真正相关。总体而言,本研究结果可能也有助于为诊断为ACS且接受PCI的患者选择治疗药物。

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