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Clinical application of VerifyNow-P2Y12 assay in evaluation of platelet inhibition efficacy of clopidogrel / 中华心血管病杂志
Chinese Journal of Cardiology ; (12): 662-666, 2012.
Article Dans Chinois | WPRIM | ID: wpr-326447
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the platelet inhibition efficacy in patients under regular maintenance dose of clopidogrel by VerifyNow-P2Y12 assay and explore the clinical characteristics of clopidogrel non-responders and related predicting factors.</p><p><b>METHODS</b>A total of 99 patients underwent percutaneous coronary intervention procedure and receiving clopidogrel in regular maintenance dose for at least 1 week were enrolled. Platelet reactivity, including baseline, P2Y12 reaction unit (PRU), and platelet inhibition rate were measured with VeifyNow-P2Y12 assay. The dosage of anti-platelet drugs, combination with any other drugs, clinical characters in baseline of all enrolled patients were analyzed. PRU ≤ 240 was used as cut-off to identify clopidogrel responder and clopidogrel non-responder. In the non-responder group, patients were further separated into 3 sub-groups (types) according to the baseline and platelet inhibition rate type I with high baseline, high inhibition rate, representing false non-responder; type II with low inhibition rate, representing true non-responder and type III mixed type.</p><p><b>RESULTS</b>In this study, 48 of 99 patients were found to be clopidogrel non-responder (48.5%). The ratio of type I, type II and type III in the non-responder group was 9.1% (n = 9), 27.3% (n = 27), and 12.1% (n = 12), respectively. Baseline platelet value in female patients was significantly higher than in males (P < 0.01), number of females with high PRU also is higher than males (P < 0.01), female gender was a predict factor for type I non-responder (OR = 6.5, 95%CI 2.295 - 18.407, P < 0.01). BMI > 24 kg/m(2) was a risk factor for clopidogrel non-responder (P < 0.05), and may be regarded as a predict factor for type II non-responder (OR = 3.207, 95%CI 1.375 - 7.485, P < 0.01). Age, hypertension, diabetics, smoking, hyperlipidemia, CRP and pantoprazole use do not show significant correlation with baseline and platelet inhibition rate.</p><p><b>CONCLUSIONS</b>Clopidogrel responses could be reliably detected by VerifyNow-P2Y12 assay. Female gender and high body weight are independent risk factors for clopidogrel non-responses.</p>
Sujets)
Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Pharmacologie / Tests fonctionnels plaquettaires / Ticlopidine / Antiagrégants plaquettaires / Angioplastie coronaire par ballonnet / Agrégation plaquettaire / Récepteurs purinergiques P2Y12 Type d'étude: Étude pronostique / Facteurs de risque Limites du sujet: Adulte très âgé / Femelle / Humains / Mâle langue: Chinois Texte intégral: Chinese Journal of Cardiology Année: 2012 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Pharmacologie / Tests fonctionnels plaquettaires / Ticlopidine / Antiagrégants plaquettaires / Angioplastie coronaire par ballonnet / Agrégation plaquettaire / Récepteurs purinergiques P2Y12 Type d'étude: Étude pronostique / Facteurs de risque Limites du sujet: Adulte très âgé / Femelle / Humains / Mâle langue: Chinois Texte intégral: Chinese Journal of Cardiology Année: 2012 Type: Article