https://scholars.lib.ntu.edu.tw/handle/123456789/466131
標題: | Residual platelet reactivity after aspirin and clopidogrel treatment predicts 2-year major cardiovascular events in patients undergoing percutaneous coronary intervention | 作者: | Chiu F.-C. TZUNG-DAU WANG JEN-KUANG LEE FUH-YUAN SHIH Lin J.-W. CHIEN-HUA HUANG WEN-JONE CHEN MING-FONG CHEN |
公開日期: | 2011 | 卷: | 22 | 期: | 5 | 起(迄)頁: | 471-477 | 來源出版物: | European Journal of Internal Medicine | 摘要: | Background: Studies on the prognostic significance of residual platelet reactivity despite the use of dual anti-platelet agents are limited and seldom extend beyond 1 year. Methods: This study enrolled 144 patients treated with standard-dose aspirin and clopidogrel and undergoing percutaneous coronary intervention (PCI). Platelet reactivity was measured by the Platelet Function Analyzer-100 (PFA-100) just before PCI and presented as collagen/epinephrine closure time (CEPI-CT) and collagen/adenosine diphosphate closure time (CADP-CT). Primary endpoint included cardiovascular death, myocardial infarction, and stroke. Secondary endpoint was the primary endpoint plus hospitalization due to unstable angina or urgent target vessel revascularization. Results: During the 24-month follow-up, 14 patients (9.7%) developed the primary endpoint events and 33 had the secondary endpoints. After controlling possible confounding factors, both CEPI-CT < 193 s and CADP-CT < 95 s were independently predictive of the primary endpoint (hazard ratio = 3.5; 95% confidence interval: 1.04-11.7; p = 0.044 and 5.3; 1.4-20.1; p = 0.015, respectively). Only CADP-CT < 95 s remained significantly predictive of secondary endpoints in the follow-up periods of 0-9 and 9-24 months, during which clopidogrel was mostly discontinued. Conclusion: This study demonstrates that increased residual platelet reactivity measured by PFA-100 CADP-CT consistently predicts the occurrence of cardiovascular events following PCI throughout the 24-month follow-up period, irrespective of the changes in anti-platelet use. ? 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/466131 | ISSN: | 0953-6205 | DOI: | 10.1016/j.ejim.2011.02.021 | SDG/關鍵字: | acetylsalicylic acid; adenosine diphosphate; adrenalin; clopidogrel; collagen; acute coronary syndrome; adult; aged; article; brain ischemia; cardiovascular disease; cardiovascular risk; drug withdrawal; female; follow up; heart infarction; heart muscle revascularization; hospitalization; human; human cell; loading drug dose; major clinical study; male; mortality; percutaneous coronary intervention; risk assessment; stable angina pectoris; stroke; thrombocyte aggregation; unstable angina pectoris; Aged; Angioplasty, Balloon, Coronary; Aspirin; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Myocardial Infarction; Platelet Activation; Platelet Aggregation Inhibitors; Preoperative Care; Prognosis; Retrospective Studies; Stroke; Survival Rate; Taiwan; Ticlopidine; Time Factors |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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