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Clinical predictors of high posttreatment platelet reactivity to clopidogrel in Koreans

机译：韩国人治疗后血小板对氯吡格雷反应性高的临床预测因素

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Introduction: High posttreatment platelet reactivity to clopidogrel (HPPR) is associated with major adverse cardiac events. However, the clinical predictors of HPPR in Asians have not been studied previously. Aims: We sought to determine clinical predictors of HPPR in Koreans. Results: We measured platelet reactivity with the VerifyNow P2Y12 assay in 1431 consecutive patients undergoing coronary angiography. We used the cut-off value of greater than 275 P2Y12 Reaction Unit (PRU) to define patients with HPPR. The clinical characteristics were compared between patients with HPPR (36.3%) and those without HPPR (63.7%). The mean age (65.4 ± 9.1 vs. 62.2 ± 9.7 years) was higher, hypertension (68.5% vs. 62.0%), diabetes mellitus (35.4% vs. 28.5%), chronic kidney disease (36.3% vs. 22.5%), renal replacement treatment (1.2% vs. 0.2%), and congestive heart failure (1.3% vs. 0.3%) were more common among patients with HPPR, while male gender (72.6% vs. 54.8%) and smoking (19.9% vs. 13.1%) were more common among non-HPPR patients. Mean glomerular filtration rate (63.5 ± 18.6 vs. 69.7 ± 16.1 mL/min/1.73 m 3) was lower and C-reactive protein (hs-CRP) (6.6 ± 20.5 mg/L vs. 4.2 ± 12.1 mg/L) level was higher among those with HPPR. Independent predictors of HPPR were female gender (OR 1.90, P≤ 0.001), chronic kidney disease (OR 1.51, 0 = 0.004), diabetes mellitus (OR 1.35, P= 0.024), hs-CRP ≥ 2.0 mg/L (OR 1.31, P= 0.005), and age increase in decades (OR 1.21, P= 0.002), while smoking was negative risk factor (OR 0.63, P= 0.015). The number of risk factors was linearly associated with the risk of HPPR, with most patients having one or two predictors. Conclusion: In Korean population, independent clinical predictors of HPPR included diabetes mellitus, increased age, female gender, chronic kidney disease, and hs-CRP ≥ 2.0 mg/L, while cigarette smoking was associated with better responsiveness. Mean platelet reactivity and HPPR prevalence steadily increased with the number of clinical predictors.
机译：简介：治疗后血小板对氯吡格雷（HPPR）的高反应性与主要不良心脏事件有关。但是，以前尚未研究过亚洲人HPPR的临床预测因素。目的：我们试图确定韩国人HPPR的临床预测指标。结果：我们用VerifyNow P2Y12测定法对1431例接受冠状动脉造影的连续患者进行了血小板反应性测量。我们使用大于275 P2Y12反应单位（PRU）的临界值来定义HPPR患者。比较有HPPR（36.3％）和无HPPR（63.7％）的患者的临床特征。平均年龄（65.4±9.1 vs. 62.2±9.7岁）更高，高血压（68.5％vs. 62.0％），糖尿病（35.4％vs. 28.5％），慢性肾脏病（36.3％vs. 22.5％），在HPPR患者中，肾脏替代治疗（1.2％vs. 0.2％）和充血性心力衰竭（1.3％vs. 0.3％）更为常见，而男性（72.6％vs. 54.8％）和吸烟（19.9％vs。 13.1％）在非HPPR患者中更为常见。平均肾小球滤过率（63.5±18.6 vs. 69.7±16.1 mL / min / 1.73 m 3）较低，C反应蛋白（hs-CRP）（6.6±20.5 mg / L vs. 4.2±12.1 mg / L）水平在HPPR患者中较高。 HPPR的独立预测因素是女性（OR 1.90，P≤0.001），慢性肾脏病（OR 1.51，0 = 0.004），糖尿病（OR 1.35，P = 0.024），hs-CRP≥2.0 mg / L（OR 1.31） ，P = 0.005）和数十岁的年龄增长（OR 1.21，P = 0.002），而吸烟是负危险因素（OR 0.63，P = 0.015）。危险因素的数量与HPPR的风险呈线性关系，大多数患者具有一个或两个预测因子。结论：在韩国人群中，HPPR的独立临床预测因素包括糖尿病，年龄增加，女性，慢性肾脏病和hs-CRP≥2.0 mg / L，而吸烟与更好的反应性相关。平均血小板反应性和HPPR患病率随着临床预测因素的数量稳定增加。

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