氯吡格雷抵抗与急性冠脉综合征患者PCI术后临床预后的关系

摘要

目的：探讨氯吡格雷抵抗对急性冠脉综合征患者经皮冠状动脉介入治疗(PCI)术后临床预后的影响。方法：入选166例急性冠脉综合征行PCI术的患者，检测服用氯吡格雷前后的血小板功能。服用氯吡格雷后血小板聚集率较基线下降≤1O%定义为氯吡格雷抵抗，根据检测结果分为抵抗组和非抵抗组，随访两组12个月的心血管事件(死亡、再次血运重建、非致死性心肌梗死、支架内血栓形成)及再次住院率。结果：两组临床特征及支架植入情况比较，差异无统计学意义(P>0.05)。抵抗组主要心血管不良事件发生率显著高于非抵抗组，抵抗组再次住院率也显著高于非抵抗组(P<0.05)。结论：急性冠脉综合征患者PCI术后存在氯吡格雷抵抗心血管不良事件发生率明显升高。%Objective:To investigate the correlation between clopidogrel resistance and long-term prognosis of acute coronary syndrome(ACS) patients implanted with drug-duting stents.Method:166 patients that undergone percutaneous coronary interventional(PCI) were enrolled.Platelet aggregation at baseline and 24 hours after clopidogrel treatment was examined.Clopidogrel resistance was defined as a decrease in platelet aggregation≤10%in response to ADP.Patients were divided into clopidogrel resistance group and clopidogrel no-resistance group. The twelve-month clinical endpoint(death,myocardial infarction,coronary revascularization and stent thrombosis)and rehospitalztion rate were compared.Result:During 12 months follow-up,the incidence of major adverse cardiovascular events was significantly higher in resistance group than that in no-resistance group(P<0.05).Hospitalization for cardiovascular events was also significantly higher in resistance meanwhile(P<0.05).Conclusion:Clopidogrel resistance may contribute to long-term prognosis of acute coronary syndrome patients implanted with drug-duting stents.