Clopidogrel-Related High Residual Platelet Reactivity Associated with Estimated Glomerular Filtration Rate in Patients with Acute Ischemic Stroke.

IF 2 Q3 PERIPHERAL VASCULAR DISEASE Cerebrovascular Diseases Extra Pub Date : 2023-01-01 Epub Date: 2023-10-09 DOI:10.1159/000534466

Yongkang Zhang, Yuan Zong, Jiarui Liu, Kangli Yin, Yuzhen Wang, Yuefeng Bian, Yichen Huang, Wei Liu, Yemin Cao

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Abstract

Introduction: There are few studies on the relationship between the occurrence of clopidogrel-related high residual platelet reactivity (HRPR) and estimated glomerular filtration rate (eGFR) at admission in patients with ischemic stroke. The aim of this study was to investigate the possible relationship between the two.

Methods: Patients who were hospitalized and diagnosed with acute ischemic stroke were recruited from July 1, 2017, to June 30, 2018, at Shanghai TCM-Integrated Hospital. Renal function was measured within 24 h of enrollment and eGFR was calculated. Patients were tested for platelet reactivity using the VerifyNow system after 7 days of antiplatelet therapy with clopidogrel 75 mg/d alone, and patients with P2Y12 reaction unit values ≥230 were diagnosed with HRPR. The association between HRPR and eGFR was analyzed.

Results: A total of 274 patients were enrolled in the study, of whom 91 (33.21%) had HRPR. Multivariate logistic regression analysis suggested that an increased risk of HRPR was independently associated with female sex and reduced eGFR (female sex: OR = 2.24, 95% CI: 1.26-3.99, p = 0.006; mild chronic kidney disease [CKD]: OR = 2.95, 95% CI: 1.47-5.93, p = 0.002; moderate CKD: OR = 3.07, 95% CI: 1.08-8.75, p = 0.04).

Conclusion: Decreased eGFR is an independent risk factor for the occurrence of HRPR in patients with ischemic stroke.

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急性缺血性卒中患者中与氯吡格雷相关的高残余血小板反应性与估计肾小球滤过率相关。

引言：关于缺血性卒中患者入院时氯吡格雷相关高残留血小板反应性（HRPR）的发生与估计肾小球滤过率（eGFR）之间关系的研究很少。本研究的目的是调查两者之间可能的关系。方法：招募2017年7月1日至2018年6月30日在上海中医综合医院住院并诊断为急性缺血性脑卒中的患者。在入组后24小时内测量肾功能，并计算eGFR。单独使用氯吡格雷75mg/d进行抗血小板治疗7天后，使用VerifyNow系统对患者进行血小板反应性测试，P2Y12反应单位值≥230的患者被诊断为HRPR。分析了HRPR与eGFR的相关性。结果：共有274名患者参与研究，其中91名（33.21%）患有HRPR。多因素逻辑回归分析表明，HRPR风险增加与女性和eGFR降低独立相关（女性：OR=2.24，95%CI:1.26-3.99，P=0.006；轻度CKD：R=2.95，95%CI:1.47-5.93，P=0.002；中度CKD：OR=3.07，95%CI=1.08-8.75，P=0.04）缺血性中风。

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来源期刊

Cerebrovascular Diseases Extra PERIPHERAL VASCULAR DISEASE-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.