Effects Of Different Doses Of Clopidogrel On Clopidogrel Resistance And Hs-CRP, P-Selectin Levels In Patients With Acute Coronary Syndrome

Objective To observe the incidence of patients with acute coronary syndrome(ACS) in different doses of clopidogrel resistance(CR) and the effects of clopidogrel on platelet aggregation and the level of serum inflammatory factors.Methods This research selected128patients with ACS and tried to PCI in the period between February2011to July2011into the treatment of Anhui Provincial Hospital Department of Cardiology. All patients are to be conventional coronary heart disease secondary prevention treatment, including taking aspirin, lipid tune medications and subcutaneous low molecular weight heparin, and were randomly divided into two groups, two groups of patients in the ACS type, gender, age, smoking status, body mass index. There is not a statistically significant with hypertension and diabetes.A group were treated with a loading dose of300mg clopidogrel followed by a maintenance dose of75mg/d, and another group were received a loading dose of600mg clopidogrel followed by a maintenance dose of150mg/d which assigned into group A and group B respectively. The turbidimetric method was used to detect the adenosine diphosphate (ADP) induced platelet aggregation rate before treatment and3days after treatment respectively. The levels of hs-CRP and P-selectin were determined by enzyme-linked immunosorbent assay (ELISA). Blood sampled before and24h and3days after pevcutaneous coronary intervention (PCI). Resultsâ‘ The occurrence rate of CR was lower in group B than that in group A(P<0.05).â‘¡The rate of platelet aggregation inhibition in CR was lower than in normal drug response individuals in both two groups. But the platelet aggregation inhibition rate in the occurrence of normal drug response and CR in group B was higher than group A(P <0.05).â‘¢The levels of serum hs-CRP and P-selectin of CR were higher than normal drug response individuals at24h and3days after PCI in both two groups. But compared with group A, in the occurrence of normal drug response and CR, the levels of serum hs-CRP and P-selectin were significantly decreased in group B(P<0.05).Conclusion CR is a clinical phenomenon, the objective existence of a serious impact on clopidogrel anti-platelet aggregation and anti-inflammatory response role, thereby affecting the prognosis of patients with ACS. Increase on the basis of a careful assessment of the risk of bleeding, to rule out the related taboo ACS for the patients underwent PCI clopidogrel loading and maintaining the availability of a more significant anti-platelet aggregation effect, to improve the platelet response to clopidogrel more effective to reduce the occurrence of CR. The same time, the high dose of clopidogrel can also effectively reduce the level of inflammatory factors, to reduce the inflammatory response in the ACS process, so that the development of coronary heart disease to the steady state. The clinical benefits brought about by the increase in the clopidogrel dose or to a certain extent even in the existence of the CR crowd. Therefore, the increase in clopidogrel dose can be regarded as a reliable method for prevention of CR.