Detection of Clopidogrel Hyporesponsiveness Using a Point-of-Care Assay and the Impact of Additional Cilostazol Administration after Coronary Stent Implantation in Diabetic Patients
The Korean Journal of Internal Medicine
;
: 145-152, 2011.
Artículo
en Inglés
| WPRIM
| ID: wpr-64780
ABSTRACT
BACKGROUND/AIMS:
Impaired responsiveness to clopidogrel is common in patients with type 2 diabetes mellitus (DM). The aim of this study was to evaluate the clinical application of a point-of-care assay to detect impaired responsiveness to clopidogrel after coronary stent implantation in patients with type 2 DM.METHODS:
We measured P2Y12 reaction units (PRU) with the VerifyNow point-of-care assay in 544 consecutive patients undergoing dual or triple (i.e., dual plus cilostazol) anti-platelet therapy after coronary stent implantation. High platelet reactivity (HPR) was defined as a PRU value > or = 240.RESULTS:
The mean PRU values were 233.5 +/- 83.2 and 190.3 +/- 85.5 in patients undergoing dual or triple anti-platelet therapy, respectively (p < 0.001). Patients with DM manifested higher post treatment PRU values (238.3 +/- 82.4 vs. 210.8 +/- 86.8, p = 0.001) and a higher frequency of HPR (44.8% vs. 31.0%, p = 0.003) as compared to patients without DM. We also found that higher PRU values and a higher frequency of HPR were present in patients with DM who were undergoing both triple and dual anti-platelet therapy. However, the higher post-treatment PRU values observed in patients with DM decreased with triple anti-platelet therapy (219.4 +/- 82.5 vs. 247.9 +/- 81.1, p = 0.044).CONCLUSIONS:
A point-of-care assay can detect elevated platelet reactivity and impaired responsiveness to clopidogrel in patients with type 2 DM. The addition of cilostazol to dual anti-platelet therapy may decrease post-treatment PRU values in patients with type 2 DM.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pruebas de Función Plaquetaria
/
Tetrazoles
/
Ticlopidina
/
Inhibidores de Agregación Plaquetaria
/
Angioplastia Coronaria con Balón
/
Distribución de Chi-Cuadrado
/
Modelos Logísticos
/
Activación Plaquetaria
/
Stents
/
Sistema de Registros
Tipo de estudio:
Estudio diagnóstico
/
Estudio de etiología
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
Asia
Idioma:
Inglés
Revista:
The Korean Journal of Internal Medicine
Año:
2011
Tipo del documento:
Artículo
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