氯吡格雷血小板反应性对经皮冠脉介入术后患者出血及缺血风险的评估效果

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Abstract Objective To investigate evaluated effect of Clopidogrel platelet reactivity on the risk of bleeding and ischemia events after percutaneous coronary intervention (PCI).Methods A total of 306 patients admitted to Cangzhou Central Hospital from January 2017 to January 2018 who had undergone PCI with drug-eluting stents and had undergone Clopidogrel platelet reactivity measurement within 48 hours after surgery were selected as the study subjects.The mean value of Clopidogrel platelet reactivity was (31.2±12.9)%.Aspirin and Clopidogrel before and after surgery were taken.Baseline information and the occurrence of bleeding and ischemia events were collected within 1 year.Results Within 1 year, bleeding events merged in 35 patients (11.4%), with ischemia events in 23 patients (7.5%).The area under the receiver operating characteristic curve (AUROC) of Clopidogrel platelet reactivity for bleeding events was 0.88,sensitivity and specificity were 74.3% and 89.3%, respectively, and the cut-off value was ≤15.0%.The AUROC of Clopidogrel platelet reactivity for ischemic events was 0.74, sensitivity and specificity were 73.9% and 77.0%, respectively, and the cut-off value was >43.7%.The number of Clopidogrel platelet reactivity in the three intervals ≤15.0%,>15.0%-43.7%, >43.7% occurring bleeding and ischemic events was 26 and 1, 9 and 5, 17 and 0, respectively.Conclusion Clopidogrel platelet reactivity presents good evaluated performance for bleeding and ischemic events in 1 year after PCI, especially for bleeding events.However, its therapeutic window needs to be further verifyed, so as to provide evidence for more individualized antithrombotic strategies.

Key words： Clopidogrel platelet reactivity Bleeding events Thrombosis events After percutaneous coronary intervention

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	ZHANG Jian-bo
	SHI Qi-yu
	HU Ya-min

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ZHANG Jian-bo,SHI Qi-yu,HU Ya-min. Evaluated effect of Clopidogrel platelet reactivity on the risk of bleeding and ischemia in patients after percutaneous coronary intervention[J]. 中国当代医药, 2020, 27(22): 8-11.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I22/8

[1]	中国心血管病预防指南（2017）写作组，中华心血管病杂志编辑委员会.中国心血管病预防指南（2017）[J].中国心血管病杂志，2018，48（1）：10-25.
[12]	徐娜，袁晋青.血小板功能检测对冠心病患者抗血小板治疗出血事件的预测价值[J].中国循环杂志，2017，32（2）：193-196.
[18]	孙彬，周杏，朱蕾，等.新型血小板功能分析仪PL-11 监测血小板聚集功能的应用价值[J].标记免疫分析与临床，2015，22（6）：569-576.
[2]	Eikelboom JW，Mehta SR，Anand SS，et al.Adverse impact of bleeding on prognosis in patients with acute coronary syndromes[J].Circulation，2006，114（8）：774-782.
[3]	Stone GW，Witzenbichler B，Weisz G，et al.Platelet reactivity and clinical outcomes after coronary artery implantation of drug eluting stents （ADAPT-DES）：a prospective multicentre registry study[J].Lancet，2013，382（9892）：614-623.
[4]	Patti G，Pasceri V，Vizzi V，et al.Usefulness of platelet response to clopidogrel by point-of-care testing to predict bleeding outcomes in patients undergoing percutaneous coronary intervention （from the Antiplatelet Therapy for Reduction of Myocardial Damage During Angioplasty-Bleeding Study）[J].Am J Cardiol，2011，107（7）：995-1000.
[5]	Kwon TJ，Tantry US，Park Y，et al.Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention.Results of the ACCEL-BLEED study[J].Thromb Haemost，2016，115（5）：979-992.
[6]	O′Gara PT，Kushner FG，Ascheim DD，et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction[J].J Am Coll Cardiol，2013，61（4）：e78-140.
[7]	Amsterdam EA，Wenger NK，Brindis RG，et al.2014 AHA/ACC guideline for the management of patients with non-STelevation acute coronarysyndromes：a report of the American College ofCardiology/American Heart Association Task Forceon Practice Guidelines[J].J Am Coll Cardiol，2014，64（24）：e139-228.
[8]	Wiviott SD，Antman EM，Gibson CM，et al.Evaluation of Prasugrel Compared With Clopidogrel in Patients With Acute Coronary Syndromes: Design and Rationale for the TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN With Prasugrel Thrombolysis In Myocardial Infarction 38 （TRITON-TIMI 38）[J].Am Heart J，2006，152（4）：627-635.
[9]	Cutlip DE，Windecker S，Mehran R，et al.Clinical end points in coronary stent trials：a case for standardized definitions[J].Circulation，2007，115（17）：2344-2351.
[10]	Thygesen K，Alpert JS，Jaffe AS，et al.Third universal definition of myocardial infarction[J].Eur Heart J，2012，33（20）：2551-2567.
[11]	Levine GN，Bates ER，Bittl JA，et al.2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease：A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J].J Thorac Cardiovasc Surg，2016，152（5）：1243-1275.
[13]	Gross L，Aradi D，Sibbing D.Platelet function testing in patients on antiplatelet medications[J].Semin Thromb Hemost，2016，42（3）：306-320.
[14]	Spiliopoulos S，Pastromas G.Current status of high ontreatment platelet reactivity in patients with coronary or peripheral arterial disease：Mechanisms，evaluation and clinical implications[J].World J Cardiol，2015，7（12）：912-921.
[15]	Collet JP，Cuisset T，Range G，et al.Bedside monitoring to adjust antiplatelet therapy for coronary stenting[J].N Engl J Med，2012，367（22）：2100-2109.
[16]	Sibbing D，Schulz S，Braun S，et al.Antiplatelet effects of clopidogrel and bleeding in patients undergoing coronary stent placement[J].J Thromb Haemost，2010，8（2）：250-256.
[17]	Breet NJ，van Werkum JW，Bouman HJ，et al.Comparison of platelet function tests in predicting clinical outcome in patients undergoing coronary stent implantation[J].JAMA，2010，303（8）：754-762.
[19]	Choi SY，Kim MH，Serebruany V.The challenge for predicting bleeding events by assessing platelet reactivity following coronary stenting[J].Int J Cardiol，2016，207（1）：128-131.
[20]	Bonello L，Mancini J，Pansieri M，et al.Relationship between post-treatment platelet reactivity and ischemic and bleeding events at 1-year follow-up in patients receiving prasugrel[J].J Thromb Haemost，2012，10（10）：1999-2005.