Clopidogrel resistance response in patients with coronary artery disease and metabolic syndrome： the role of hyperglycemia and obesity  

作　　者：Zhao-Ke WU Jing-Jing WANG Ting WANG Shen-Shen ZHU Xi-Ling CHEN Chao LIU Wei-Guo ZHANG 

机构地区：[1]Department of Gerontology, the Second Affiliated Hospital of Zhengzhou Universi(y, Zhengzhou, Henan, China [2]Department of neurology, the First Provincial Hospital of Henan Province, Zhengzhou, Henan, China [3]Department of Gerontology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China [4]Department of Cardiology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China

出　　处：《Journal of Geriatric Cardiology》2015年第4期378-382,共5页老年心脏病学杂志（英文版）

摘　　要：Background Despite the proven benefits of clopidogrel combined aspirin therapy for coronary artery disease （CAD）, CAD patients with metabolic syndrome （MS） still tend to have coronary thrombotic events. We aimed to investigate the influence of metabolic risk factors on the efficacy of clopidogrel treatment in patients with CAD undergoing percutaneous coronary intervention （PCI）. Methods Cohorts of 168 MS and 168 non-MS subjects with CAD identified by coronary angiography （CAG） were enrolled in our study. MS was defined by modified Adult Treatment Panel Ⅲ criteria. All subjects had taken 100 mg aspirin and 75 mg clopidogrel daily for more than 1 month, and administered loading doses of 600 mg clopidogrel and 300 mg aspirin before PCI. Blood samples were taken 24 h after the loading doses of clopidogrel and aspirin. Platelet aggregation was measured using light transmittance aggregometry （LTA） and thrombelastography （TEG）. Clopidogrel resistance was defined as more than 50% adenosine diphosphate （ADP） induced platelet aggregation as measured by TEG. Re- sults Platelet aggregation inhibition rate by ADP was significantly lower in patients with MS as measured both by TEG （55% ＋ 31% vs. 68% ± 32%; P 〈 0.001） and LTA （29% ± 23% vs. 42% ± 29%; P 〈 0.001）. In the multivariate analysis, elderly [OR （95% CI）： 1.483 （1.047±.248）; P = 0.002], obesity [OR （95% CI）： 3.608 （1.241-10.488）; P = 0.018], high fasting plasma glucose level [OR （95% CI）： 2.717 （1.176±.277）; P = 0.019] and hyperuricemia [OR （95% CI）： 2.583 （1.095-6.094）; P = 0.030] were all statistically risk factors for clopido- grel resistance. CAD patients with diabetes and obesity were more likely to have clopidogrel resistance than the CAD patients without dia- betes and obesity [75% （61/81） vs. 43% （67/156）; P 〈 0.001]. Conclusions CAD patients with MS appeared to have poorer antiplatelet response to clopidogrel compared to those without MS. Obesity, diabetes and hy

关 键 词：Clopidogrel resistance Coronary artery disease Metabolic syndrome 

分 类 号：Q51[生物学—生物化学] TQ463.5[化学工程—制药化工]