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【JACC】血浆纤维蛋白原增高及糖尿病与氯吡格雷
Elevated Plasma Fibrinogen and Diabetes Mellitus Are Associated With Lower Inhibition of Platelet Reactivity With Clopidogrel
abstract:
Elevated Plasma Fibrinogen and Diabetes Mellitus Are Associated With Lower Inhibition of Platelet Reactivity With Clopidogrel
Lawrence Ang, BS, Vachaspathi Palakodeti, MD, FACC, Ahmer Khalid, BS, Sotirios Tsimikas, MD, FACC, Zaheib Idrees, BS, Phillip Tran, MD, Paul Clopton, MS, Nayab Zafar, MD, Guilherme Bromberg-Marin, MD, Shahin Keramati, MD, FACC and Ehtisham Mahmud, MD, FACC*
Division of Cardiovascular Medicine, University of California, San Diego School of Medicine, San Diego, California
Manuscript received January 6, 2008; revised manuscript received May 27, 2008, accepted May 28, 2008.
* Reprint requests and correspondence: Dr. Ehtisham Mahmud, Cardiovascular Catheterization Laboratories, UCSD Medical Center, 200 West Arbor Drive, San Diego, California 92103 (Email: emahmud@ucsd.edu).
Objectives: The goal of this study was to identify factors associated with lower platelet inhibition (PI) with clopidogrel in subjects with cardiovascular disease (CVD).
Background: A heterogeneous platelet reactivity response to clopidogrel exists, and the clinical or biochemical predictors of suboptimal PI with clopidogrel remain unclear.
Methods: This study prospectively enrolled subjects with CVD requiring treatment with clopidogrel (75 mg daily for 7 days or 600-mg bolus 24 h before recruitment). A bedside rapid platelet function assay (VerifyNow, Acccumetrics, San Diego, California) to measure maximal and clopidogrel-mediated platelet reactivity was utilized, and factors associated with lower PI were identified.
Results: A heterogeneous, normally distributed PI (mean 40.8 ± 26.2%) response to clopidogrel was observed in 157 subjects (age 67.2 ± 12.2 years; 59.9% men). Multiple variable analysis of clinical and biochemical factors known to affect platelet reactivity revealed lower PI in patients with an elevated plasma fibrinogen level (375 mg/dl), diabetes mellitus, and increased body mass index (BMI) (25 kg/m2). On testing for interaction, elevated fibrinogen level was associated with diabetic status, resulting in lower PI in diabetic patients (23.9 ± 3.9% vs. 45.1 ± 4.5%, p < 0.001), but not nondiabetic patients (44.7 ± 4.4% vs. 46.3 ± 4.8%, p = 0.244). Increased BMI remained independently associated with lower PI after clopidogrel therapy regardless of diabetic status or fibrinogen level (36.8 ± 9.0% vs. 49.0 ± 7.0%, p < 0.001).
Conclusions: Elevated plasma fibrinogen (375 mg/dl) in the presence of diabetes mellitus and increased BMI (25 kg/m2) are associated with lower PI with clopidogrel in patients with CVD. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 楼上没有翻译咯～
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Elevated Plasma Fibrinogen and Diabetes Mellitus Are Associated With Lower Inhibition of Platelet Reactivity With Clopidogrel
血浆纤维蛋白原增高及糖尿病会降低氯吡格雷的抗血小板作用
Lawrence Ang, BS, Vachaspathi Palakodeti, MD, FACC, Ahmer Khalid, BS, Sotirios Tsimikas, MD, FACC, Zaheib Idrees, BS, Phillip Tran, MD, Paul Clopton, MS, Nayab Zafar, MD, Guilherme Bromberg-Marin, MD, Shahin Keramati, MD, FACC and Ehtisham Mahmud, MD, FACC*
Division of Cardiovascular Medicine, University of California, San Diego School of Medicine, San Diego, California
加利福尼亚州，圣地亚哥，加利福尼亚州立大学圣地亚哥医学院，心血管科
Manuscript received January 6, 2008; revised manuscript received May 27, 2008, accepted May 28, 2008.
* Reprint requests and correspondence: Dr. Ehtisham Mahmud, Cardiovascular Catheterization Laboratories, UCSD Medical Center, 200 West Arbor Drive, San Diego, California 92103 (Email: emahmud@ucsd.edu).
Objectives: The goal of this study was to identify factors associated with lower platelet inhibition (PI) with clopidogrel in subjects with cardiovascular disease (CVD).
目的：研究目的是为了确定哪些因素会降低氯吡格雷对心血管病（CVD）患者的血小板抑制作用（PI）。
Background: A heterogeneous 编译：
血小板对氯吡格雷的反应性存在异质性，而且以氯砒格雷作为次选血小板抑制剂的临床或生物化学预测尚不清楚。因此加利福尼亚州立大学圣地亚哥医学院心血管科的研究人员为了确定影响氯吡格雷血小板抑制作用（PI）的因素对心血管病（CVD）患者进行了一项研究。
受试者为需用氯吡格雷治疗的CVD患者，并在纳入研究前进行过7天75mg/天或600mg/24h大剂量的氯砒格雷治疗。研究采用一种快速临床血小板功能检测法测定最大的血小板聚集浓度及氯吡格雷介导的血小板聚集浓度，并确定与血小板抑制作用下降有关的因素。
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作者:admin@医学,生命科学 2010-10-14 05:11
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