新型ADP受体阻滞剂时代的治疗中血小板反应性:来自真实世界临床实践的数据

I. Škorňová, M. Samoš, R. Šimonová, J. Žolková, L. Stančiaková, Ľ. Vádelová, T. Bolek, L. Urban, F. Kovář, J. Staško, P. Galajda, P. Kubisz, M. Mokáň
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引用次数: 1

摘要

摘要目的:一些研究质疑在接受新型ADP受体阻滞剂(ADPRB)治疗的患者中进行血小板功能检测的必要性。本研究的目的是评估急性st段抬高型心肌梗死(STEMI)患者接受较新的ADPRB治疗时,高治疗期血小板反应性(HTPR)的患病率。方法:一项前瞻性研究纳入44例急性既往ADPRB未发STEMI患者(31男,13女),接受原发性经皮冠状动脉介入治疗(pPCI)。在研究人群中,23名患者接受普拉格雷治疗,21名患者接受替格瑞洛治疗。采用光透射聚集法(LTA)和血管扩张剂刺激磷酸化(VASP-P)流式细胞术检测抗血小板反应。分别于冠状动脉造影前(样本1)和造影后第二天(样本2)采集样本。结果:样本1经ADP诱导后平均血小板聚集率为51.7±24.8%,样本2为25.3±20.1%。VASP-P检查显示,样本1和样本2的平均血小板反应指数分别为56.8±25.7%和23.8±23.1%。该研究确定样本2中11.4%的患者为ADP受体阻滞剂无反应。在接受普拉格雷治疗的患者和接受替格瑞治疗的患者之间没有发现显著差异。结论:这项初步研究证实了HTPR在接受较新的ADPRB治疗的急性STEMI患者中存在。
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On-treatment platelet reactivity in the era of new ADP receptor blockers: data from a real-world clinical practice
Abstract Objectives: Several studies have questioned the need for platelet function testing in patients treated with new ADP receptor blockers (ADPRB). The aim of this study was to evaluate the prevalence of high on-treatment platelet reactivity (HTPR) among acute ST-elevation myocardial infarction (STEMI) patients treated with newer ADPRB. Methods: A prospective study enrolling 44 acute previously ADPRB naive STEMI patients (31 men, 13 women) undergoing primary percutaneous coronary intervention (pPCI) was performed. Among the studied population 23 patients received prasugrel and 21 patients received ticagrelor. Antiplatelet response was tested with light transmission aggregometry (LTA) and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) flow cytometry assay. Samples were taken prior to coronary angiography (sample 1) and on the day after this procedure (sample 2). Results: The mean platelet aggregation after induction with ADP was 51.7 ± 24.8% in sample 1 and 25.3 ± 20.1% in sample 2. An examination of VASP-P showed a mean platelet reactivity index of 56.8 ± 25.7% in sample 1 and 23.8 ± 23.1% in sample 2, respectively. The study identified 11.4% of patients in sample 2 as ADP receptor blocker non-responders. No significant differences were found between prasugrel-treated to ticagrelor-treated patients. Conclusions: This pilot study demonstrated HTPR among acute STEMI patients treated with newer ADPRB.
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来源期刊
自引率
0.00%
发文量
11
审稿时长
14 weeks
期刊介绍: Acta Medica Martiniana is a medical scientific journal, first published in print form in December 2001. It is a continuation of the journal / almanac Folia Medica Martiniana (1971 - 1996). The journal‘s owner is the Jessenius Faculty of Medicine, Comenius University, Slovakia. Dissemination of research results and scientific knowledge from all areas of medicine and nursing. Stimulation, facilitation and supporting of publication activity for the young medical research and clinical generation. The contributions of young novice authors (PhD students and post-doctorials) are particularly welcome. Acta Medica Martiniana is an open-access journal, with a periodicity of publishing three times per year (Apr/Aug/Dec). It covers a wide range of basic medical disciplines, such as anatomy, histology, biochemistry, human physiology, pharmacology, etc., as well as all clinical areas incl. preventive medicine, public health and nursing. Interdisciplinary and multidisciplinary manuscripts, including papers from all areas of biomedical research, are welcome.
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