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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Platelet Function Testing in Patients with Acute Ischemic Stroke: An Observational Study
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Platelet Function Testing in Patients with Acute Ischemic Stroke: An Observational Study

机译：急性缺血性卒中患者的血小板功能试验：观察学研究

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Background: The measurement of platelet reactivity in patients with stroke undergoing antiplatelet therapies is not commonly performed in clinical practice. We assessed the prevalence of therapy responsiveness in patients with stroke and further investigated differences between patients on prevention therapy at stroke onset and patients naive to antiplatelet medications. We also sought differences in responsiveness between etiological subtypes and correlations between Clopidogrel responsiveness and genetic polymorphisms. Methods: A total of 624 stroke patients on antiplatelet therapy were included. Two different groups were identified: "non-naive patients", and "naive patients". Platelet function was measured with multiple electrode aggregometry, and genotyping assays were used to determine CYP2C19 polymorphisms. Results: Aspirin (ASA) responsiveness was significantly more frequent in naive patients compared with non-naive patients (94.9% versus 82.6%, P <.0010). A better responsiveness to ASA compared with Clopidogrel or combination therapy was found in the entire population (P <.0010), in nonnaive patients (P <.0253), and in naive patients (P <.0010). Multivariate analysis revealed a strong effect of Clopidogrel as a possible "risk factor" for unresponsiveness (odds ratio 3.652, P <.0001). No difference between etiological subgroups and no correlations between responsiveness and CYP2C19 polymorphisms were found. Conclusion: In our opinion, platelet function testing could be potentially useful in monitoring the biological effect of antiplatelet agents. A substantial proportion of patients with stroke on ASA were "resistant", and the treatment with Clopidogrel was accompanied by even higher rates of unresponsiveness. Longitudinal studies are needed to assess whether aggregometry might supply individualized prognostic information and whether it can be considered a valid tool for future prevention strategies. (c) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：临床实践中，中风患者血小板反应性的测量不一致。我们评估了患者卒中患者治疗反应性的患病率，并进一步调查了患者在中风发作和患者对抗血小板药物的患者。我们还在病原亚型与氯吡格雷响应性与遗传多态性之间的相关性之间寻求差异。方法：还包括抗血小板治疗的624例中风患者。鉴定了两组不同的群体：“非天真患者”和“天真患者”。用多电极聚集体测量血小板功能，使用基因分型测定来确定CYP2C19多态性。结果：与非天真患者相比，幼稚患者阿司匹林（ASA）反应性在幼稚患者中显着频繁（94.9％对82.6％，P <.0010）。与氯吡格雷或联合治疗相比，在非洲患者（P <0.0253）和幼稚患者（P <.0010）中，对氯吡格雷或联合治疗相比，对ASA的更好反应性。多变量分析揭示了氯吡格雷作为可能的“风险因素”的强烈效果，无响应（赔率比3.652，P <.0001）。病因亚组之间没有发现响应性与CYP2C19多态性之间没有相关性。结论：在我们看来，血小板函数测试可能在监测抗血小板药物的生物学效果方面可能是有用的。大部分脑卒中患者患有“抗性”，用氯吡格雷的治疗伴随着更高的反应速度。需要纵向研究来评估聚体是否可能提供个性化预后信息以及是否可以被视为未来预防策略的有效工具。 （c）2017国家冲程协会。由elsevier Inc.保留所有权利发布。

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