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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Predictive Value of High Residual Platelet Reactivity by Flow Cytometry for Outcomes of Ischemic Stroke Patients on Clopidogrel Therapy
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Predictive Value of High Residual Platelet Reactivity by Flow Cytometry for Outcomes of Ischemic Stroke Patients on Clopidogrel Therapy

机译：流式细胞术测定高残留血小板反应性对氯吡格雷治疗缺血性卒中患者结果的预测价值

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High residual platelet reactivity (HRPR) assessed by multiple tests has been associated with worse clinical outcomes. However, the clinical impact of HRPR assessed by flow cytometry is unknown. The aim of this study was to validate the predictive value of HRPR measured by flow cytometry for clinical outcomes in ischemic stroke patients during clopidogrel therapy. Overall, 198 consecutive patients with ischemic stroke taking clopidogrel underwent platelet function testing on flow cytometer including adenosine diphosphate (ADP)-induced platelet aggregation (PAg) and platelet activation markers (CD62P, CD63, and PAC-1). Poor outcome was defined as poor prognosis and ischemic events during 12-month follow-up. By receiver operating characteristic curve analysis, residual platelet reactivity assessed by flow cytometry was able to distinguish between patients with and without poor outcomes, when platelet inhibition was evaluated with ADP-PAg (area under the curve [AUC], .77; 95% confidence interval [CI], .69-.84; P<.001), CD62P (AUC, .73; 95% CI, .64-.81; P<.001), CD63 (AUC, .72; 95% CI, .64-.80; P<.001), and PAC-1 (AUC, .70; 95% CI, .62-.78; P<.001). The prevalence of HRPR was 25.8% for ADP-PAg, 32.8% for CD62P, 41.4% for CD63, and 56.1% for PAC-1. The multiple logical regression analysis demonstrated that HRPR was an independent predictor of poor outcomes (ADP-PAg: odds ratio [OR] 13.03, 95% CI 5.66-29.98, P<.001; CD62P: OR 8.55, 95% CI 3.94-18.57, P<.001; CD63: OR 8.74, 95% CI 3.89-19.64, P<.001; PAC-1: OR 4.23, 95% CI 1.98-9.08). In conclusion, HRPR, assessed by flow cytometry, is able to detect ischemic stroke patients at increased risk of 12-month poor outcomes on clopidogrel treatment. (C) 2015 by National Stroke Association
机译：通过多项测试评估的高残留血小板反应性（HRPR）与较差的临床结果相关。但是，通过流式细胞术评估HRPR的临床影响尚不清楚。这项研究的目的是验证通过流式细胞术测量的HRPR对氯吡格雷治疗期间缺血性卒中患者的临床结局的预测价值。总体上，连续198位接受氯吡格雷的缺血性卒中患者在流式细胞仪上进行了血小板功能测试，其中包括二磷酸腺苷（ADP）诱导的血小板聚集（PAg）和血小板活化标志物（CD62P，CD63和PAC-1）。预后不良被定义为12个月的随访中预后不良和缺血性事件。通过接受者操作特征曲线分析，当用ADP-PAg评估血小板抑制作用时，通过流式细胞术评估的残余血小板反应性能够区分有无不良结果的患者（曲线下面积[AUC] ，. 77; 95％置信度）区间[CI] ，. 69-.84; P <.001），CD62P（AUC，.73; 95％CI，.64-.81; P <.001），CD63（AUC，.72; 95％CI ，.64-.80; P <.001）和PAC-1（AUC，.70; 95％CI，.62-.78; P <.001）。 HRPR的患病率：ADP-PAg为25.8％，CD62P为32.8％，CD63为41.4％，PAC-1为56.1％。多元逻辑回归分析表明，HRPR是不良预后的独立预测因子（ADP-PAg：优势比[OR] 13.03，95％CI 5.66-29.98，P <.001; CD62P：OR 8.55，95％CI 3.94-18.57 ，P <.001; CD63：或8.74，95％CI 3.89-19.64，P <.001; PAC-1：或4.23，95％CI 1.98-9.08）。总之，通过流式细胞术评估的HRPR能够检测出接受氯吡格雷治疗12个月不良结局风险增加的缺血性中风患者。 （C）国家卒中协会2015年

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