Suppr
超能文献

经皮冠状动脉介入治疗的心房颤动患者中通过血栓弹力图评估的血小板反应性和纤维蛋白凝块强度

Platelet Reactivity and Fibrin Clot-Strength as assessed by TEG in Patients with Atrial Fibrillation undergoing Percutaneous Coronary Intervention.

作者信息

Gjermeni Diona, Vetter Hannah, Szabó Sofia, Anfang Viktoria, Juelch Carina, Leggewie Stefan, Hesselbarth David, Jäckel Markus, Duerschmied Daniel, Trenk Dietmar, Westermann Dirk, Olivier Christoph B

机构信息

Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg - Bad Krozingen, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.

Department of Cardiology, Haemostaseology and Medical Intensive Care, Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.

出版信息

J Cardiovasc Transl Res. 2025 Aug 27. doi: 10.1007/s12265-025-10673-4.

DOI:10.1007/s12265-025-10673-4

PMID:40866669

Abstract

Platelet reactivity (PR) in clopidogrel-treated patients undergoing percutaneous coronary syndrome (PCI) associates with ischemic and bleeding risk. The aim was to investigate the association of PR and global hemostasis with this risk in patients with atrial fibrillation (AF) undergoing PCI. TEG was performed on day 1-3 after PCI. 168 patients were included. Mean age was 79 years (IQR 72-82). 101 (60%) patients had high platelet reactivity (HPR). HPR was not associated with the composite outcome of MACE (HR 1.23 [ CI 95% 0.43-3.49], p = 0.700). 33(19.6%) patients had HPR and increased platelet-fibrin clot strength and showed a trend for association with higher ischemic risk (HR 2.83 [CI 95% 0.70-8.06], p = 0.078). Rates of HPR in patients with AF undergoing PCI were high. Neither HPR nor LPR predicted ischemic or bleeding risks. Patients with HPR and increased platelet-fibrin clot strength may be at higher risk for ischemic events.

摘要

接受经皮冠状动脉介入治疗（PCI）的氯吡格雷治疗患者的血小板反应性（PR）与缺血和出血风险相关。本研究旨在探讨接受PCI的心房颤动（AF）患者中PR和整体止血与该风险的相关性。在PCI术后第1 - 3天进行血栓弹力图（TEG）检测。共纳入168例患者。平均年龄为79岁（四分位间距72 - 82岁）。101例（60%）患者具有高血小板反应性（HPR）。HPR与主要不良心血管事件（MACE）的复合结局无关（风险比[HR] 1.23 [95%置信区间（CI）0.43 - 3.49]，p = 0.700）。33例（19.6%）患者具有HPR且血小板 - 纤维蛋白凝块强度增加，显示出与较高缺血风险相关的趋势（HR 2.83 [CI 95% 0.70 - 8.06]，p = 0.078）。接受PCI的AF患者中HPR发生率较高。HPR和低血小板反应性（LPR）均不能预测缺血或出血风险。具有HPR且血小板 - 纤维蛋白凝块强度增加的患者可能发生缺血事件的风险更高。