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首页> 外文期刊>Scandinavian journal of clinical and laboratory investigation. >On-treatment platelet reactivity in peripheral and coronary blood in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI)
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On-treatment platelet reactivity in peripheral and coronary blood in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI)

机译：患有初级PCI对ST段抬高心肌梗死（Stemi）患者外周血和冠状血液中的治疗血小板反应性（STEMI）

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Dual antiplatelet therapy is recommended in patients undergoing primary percutaneous coronary intervention (p-PCI) for ST-segment elevation myocardial infarction (STEMI). Pre-analytical variables may influence platelet function analysis results. Our aim was to evaluate the on-treatment platelet reactivity in peripheral artery vs coronary blood in patients with STEMI. We enrolled one hundred and nine patients who consecutively underwent p-PCI at Cardiology Unit of Padua University Hospital between June 2014 and June 2015. Before the procedure, all patients received intravenous aspirin 250mg and either of the thienopyridines; clopidogrel 600mg, prasugrel 60mg or ticagrelor 180mg. ASPI-test and ADP-test using multiple electrode aggregometry (MEA) were performed in samples collected from both a peripheral artery and the culprit coronary artery. Low responders' were patients with an ASPI-test or ADP-test value greater than or equal to a pre-established normal range. No significant differences were observed in ASPI-test values between peripheral (19 (median) [3-49 (10-90 percentiles)] U) vs coronary (12 [1-40] U, p = .06) blood and in ADP-test (40 [14-82] U vs 33 [7-79] U, p = .68) blood. In peripheral blood, fifteen (14%) patients were low aspirin' and forty-one (38%) low thienopyridines' responders. The prevalence of low clopidogrel' responders was higher (45%) than prasugrel (36%) and ticagrelor (33%). Similar results were observed in coronary blood. In patients undergoing p-PCI for STEMI, MEA platelet function observed in coronary arteries was consistent with peripheral artery blood's independently of the antiplatelet drug used. The clinical significance of peripheral and coronary on-aspirin/thienopyridines platelet reactivity needs further clarification.
机译：建议在经过经皮冠状动脉介入（P-PCI）的患者对ST段抬高心肌梗死（STEMI）进行双抗血小板治疗。预分析变量可能影响血小板函数分析结果。我们的目的是评估STEMI患者外周动脉VS冠状血液中的治疗血小板反应性。我们注册了一百九年九月至2015年6月至2015年6月在帕多瓦大学医院的心脏病学单位接受了一百九名患者的患者。在该程序之前，所有患者均接受静脉内阿司匹林250mg和噻吩吡啶;氯吡格雷600mg，prasugrel60mg或ticagrelor 180mg。使用多电极聚集体（MEA）的ASPI-TEST和ADP-TEST在从两个外周动脉和罪魁祸首冠状动脉收集的样品中进行。低响应者是患者的患者或adp-test值大于或等于预先建立的正常范围。在外周（19（中位数）[3-49（10-90百分位数）] u）之间的ASPI - 试验值中没有显着差异，冠状动脉（12 [1-40] U，P = .06）血液和ADP - 最低（40 [14-82] U VS 33 [7-79] U，P = .68）血液。在外周血中，十五（14％）患者低阿司匹林和四十一（38％）低噻吩吡啶的响应者。低氯吡格雷'响应者的患病率高（45％）比普拉布雷（36％）和TiCagreloR（33％）。在冠状动脉血中观察到类似的结果。在接受P-PCI的患者中，在冠状动脉中观察到的MEA血小板函数与外周动脉血液无关的抗血小板药物。外周血和冠状动脉冠状动脉/噻吩吡啶血小板反应性的临床意义进一步澄清。

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