Clinical Research Of Clopidogrel Resistance

Purpose:●Evaluate the incidence rate of Clopidogrel resistance.●Analyze in various types of CHD(Coronary Heart Disease) patients the degree of platelet aggregation inhibition(DPAI) differentiation and influential factors.●Conduct a 1 year observation of MACCE and show interrelation of the figures.●Make an overall evaluation of the clinical significance of Clopidogrel's reaction to different severity degrees of CHD and Cardio-Encephalo Vascular incidents.Method:In 107 patients on standard Clopidogrel and Aspirin treatment,record the clinical traits, biochemical blood works,coronary angiography(CAG) results,and follow up of the 1 year MACCE results.5～7 days prior to medicine usage distinguish venous DPAI figures. (＜10%=Resistance,10%～29%=Semi-Resistance,≥30%=Normal).Results:1.Excluding 6 cases(5.6%) Amongst the patients there proved to be 19 normal cases (18.8%),24 SAP cases(23.8%),and 58 ACS cases(57.4%).Hs-CRP levels and severe pathological change numbers proportionally increased as pathological situations increased in severity(P＜0.05).When the ACS group was admitted to the hospital,SBP baseline figures were lower than those of the SAP group and the Normal group(P=0.047).Coronary Artery Disease severe change numbers wer relevant to clinical differentiation,age,hs-CRP,and GLU levels(P＜0.05).2.Amongst patients there proved to be 36 Resistance cases(35.6%),32 Semi-Resistance cases(31.7%),and 33 Normal cases(32.7%).As severity of clinical symptoms increased,DPAI figures gradually decreased(P=0.012),therefore CR incidence rate had the tendency to increase(P=0.052).3.In the analysis of patients 1 year after being discharged from the hospital,there proved to be 61 cases with stable pathological conditions(60.4%) and 26 MACCE cases(25.7%).Amongst these were 19 UAP cases(18.8%),2 AMI cases(2%),3 Stroke cases(3%) and 2 cases of death(2%).Otherwise,there were 7 cases that needed another treatment of PCI therapy(6.9%),8 cases of hemorrhage complications(7.9%),and 14 cases of "others"(13.9%).As to thee occurrence of MACCE during hospital admittance,DPAI had a relevance of(P=0.009),MACCE incidence rate proportionally increased as CR increased in severity(P=0.023),and as whether or not HT had relation(P=0.043).Hemorrhage and patient sex had a relevance of(P=0.023) and with blood fat levels had a relevance of(P＜0.05).Conclusion:1.As CHD patients degrees of peril increased,DPAI figures significantly decreased proving that ACS patients' platelet activation,adhesion,and agglutination rate had increased and the risk of CR occurrence had increased.This concludes that DPAI figures are a reliable marker that can be used to evaluate CR.2.The DPAI figures in patients with an incidence of MACCE were significantly lower than those in stable patients.Risk of reoccurring cardio-encephalo thrombus increased.This,therefore,can be used as a clinical prognosis guide.3.In the 1 year follow up,there were no severe hemorrhage occurrences.However, minimal hemorrhage was relevant to patients of the female sex and blood fat levels. Whether or not it was Clopidogrel sensitivity had no relation,therefore, anti-thrombolytic therapy is safe and effective.