Influence of aspirin/clopidogrel treatment on platelet aggregation rate and analysis of drug resistance in the patients with coronary heart disease
10.3760/cma.j.issn.1008-1372.2017.09.022
- VernacularTitle:阿司匹林/氯吡格雷治疗对冠心病患者血小板聚集率的影响及其药物抵抗相关因素分析
- Author:
Peng ZENG
1
;
Yingxu MA
;
Fei LUO
;
Ran PENG
;
Guiyun RUAN
;
Jia PENG
;
Xiangping LI
Author Information
1. 湖南省邵阳市中心医院心内科
- Keywords:
Aspirin/TU;
Ticlopidine/AA/TU;
Coronary disease/DT;
Platelet aggregation/DE;
Drug resistance
- From:
Journal of Chinese Physician
2017;19(9):1366-1369
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of aspirin and/or clopidogrel treatment on platelet aggregation rate in coronary heart disease (CHD) patients,and discuss the factors related to anti-platelet drug resistance.Methods A total of 160 patients with CHD and received aspirin and/or clopidogrel treatment were enrolled in the Second Xiangya Hospital,Central South University,and were divided into stable coronary heart disease (SCHD) group (n =90) and acute coronary syndrome (ACS) group (n =70).Meanwhile,non-coronary heart disease (NCHD) patients who did not receive anti-platelet drug treatment were enrolled as controls (n =50).Clinical data of the subjects were recorded.The maximum platelet aggregation rate induced by arachidonic acid (MAR-AA) and adenosine diphosphate (MAR-ADP) were evaluated with sequential platelet counting method.The factors related to drug resistance were analyzed with Logistic regression analysis.Results Compared to NCHD group,there were lower MAR-AA and MAR-ADP in two groups of CHD (all P ＜ 0.05).In ACS patients,MAR-AA and MAR-ADP are significantly lower (P ＜0.05) in patients who receive the aspirin and clopidogrel.The rate of anti-platelet drug resistance in ACS group was significantly higher than that in SCHD group (20.0％ vs 10.0％,P ＜ 0.05).Multivariate logistic regression analysis showed that low HDL-C (＜ 1.0 mmol/L) was an independent risk factor related to the anti-platelet drug resistance (OR =4.36,95 ％ CI:1.36-14.02,P =0.025).Conclusions The antiplatelet treatment with aspirin and/or clopidogrel can significantly reduce the platelet reactivity in CHD patients,but some patients still present anti-platelet drug resistance.The combination of aspirin and clopidogrel is better.The rate of drug resistance in ACS patients is high.Low HDL-C might be associated with anti-platelet drug resistance.
