VerifyNow P2Y12血小板反应性检测对评估冠状动脉血运重建患者的临床疗效的meta分析  

Effects of VerifyNow P2Y12 test on clinical outcomes of patients with coronary revascularization: A meta-analysis

作　　者：刘畅[1] 马依彤[1] 于子翔[1] 杨毅宁[1] 李晓梅[1] 

机构地区：[1]新疆医科大学第一附属医院心脏中心冠心病科,新疆乌鲁木齐830054

出　　处：《心脏杂志》2015年第5期577-581,共5页Chinese Heart Journal

基　　金：教育部"创新团队发展计划"项目资助(IRT13094)

摘　　要：目的评价VerifyNow P2Y12血小板反应性检测对使用氯吡格雷的冠状动脉血运重建患者的长期临床预后的意义。方法计算机检索Cochrane图书馆（2014年第3期）、PubMed、EMbase、Highwire、CBM、CNKI等中外生物医学数据库。收集关于对冠状动脉血运重建患者实施VerifyNowP2Y12检测,随访时间为6~12个月的随机对照临床试验以及队列研究,检索日期截止至2014年3月。提取有效数据后采用STATA 12.0软件进行Meta分析。结果本meta分析纳入14项研究,共计17 643名患者,结果显示：VerifyNow P2Y12检测出的血小板高反应性组的全因病死率高〔RR=1.572,95%CI（1.220,2.025）,P=0.000〕,再次心肌梗死发生率高〔RR=1.981,95%CI（1.443,2.720）,P=0.000〕,支架内血栓发生率高〔RR=2.205,95%CI（1.643,2.960）,P=0.000〕,卒中发生率高〔RR=2.288,95%CI（1.195,4.380）,P=0.012〕,而对于靶血管重建,两组结果差异无统计学意义〔RR=1.148,95%CI（0.809,1.629）,P=0.439〕。结论VerifyNow P2Y12血小板反应性检测对服用氯吡格雷患者的全因死亡、心肌梗死、支架内血栓、卒中等心血管事件有预测价值。AIM To investigate the effects of VerifyNow P2Y12 test on the clinical outcomes of patients taking clopidogrel undergoing coronary revascularization. METHODS We searched the Cochrane Library （2014 Section 3）, Pubmed, EMbase, Highwire, CBM, CNKI and other biomedical databases and collected data as of March 2014 of VerifyNow P2Y12 test in patients with coronary revascularization, follow-up time of 6 - 12 months, randomized controlled trials and cohort studies. After extracting valid data, a meta-analysis was conducted using STATA 12.0 software. RESULTS The meta-analysis included 14 studies with a total of 17 643 patients. The results showed that the detection rate of VerifyNow P2Y12 test was high in all-cause mortality （RR = 1. 572, 95% CI 1. 220, 2. 025, P = 0. 000）, incidence of myocardial infarction （ RR = 1. 981, 95% CI 1. 443, 2. 720, P =0. 000）, stent thrombosis rate （ RR = 2. 205, 95% CI 1. 643, 2. 960, P = 0. 000） and incidence of stroke （ RR = 2. 288, 95% CI 1. 195,4. 380, P =0. 0129）. For target vessel revascularization, two sets of results showed no significant difference （RR = 1. 148, 95% CI 0. 809, 1. 629, P = 0. 439）. CONCLUSION VerifyNow P2Y12 platelet reactivity detection has predictive value for all-cause death, myocardial infarction, stent thrombosis,stroke and other cardiovascular events in patients taking clopidogrel.

关 键 词：VerifyNow P2Y12 氯吡格雷 冠状动脉粥样硬化性心脏病 META分析 

分 类 号：R541.4[医药卫生—心血管疾病] R973.2[医药卫生—内科学]