Am J Cardiol:代谢综合征显著影响抗血小板药反应性

2013-11-07 高晓方 译 医学论坛网

法国一项研究表明,肥胖对氯吡格雷和普拉格雷治疗的血小板反应性具有强烈影响,在肥胖患者中, 代谢综合征(MS)的存在强烈影响着抗血小板药物的应答,提示代谢状态可能是血小板抑制的更好预测因子。论文10月31日在线发表于《美国心脏病学杂志》(Am J cardiol)。 此项研究共纳入1542例接受冠脉支架置入的序贯性患者,其中接受氯吡格雷75 mg、氯吡格

法国一项研究表明,肥胖对氯吡格雷和普拉格雷治疗的血小板反应性具有强烈影响,在肥胖患者中, 代谢综合征(MS)的存在强烈影响着抗血小板药物的应答,提示代谢状态可能是血小板抑制的更好预测因子。论文10月31日在线发表于《美国心脏病学杂志》(Am J cardiol)。

此项研究共纳入1542例接受冠脉支架置入的序贯性患者,其中接受氯吡格雷75 mg、氯吡格雷150 mg和普拉格雷 10mg治疗者分别为287、868和387例。利用PRI-VASP评估出院1个月后血小板活性。BMI≥30的肥胖患者为336例(21.8%)。

结果显示,肥胖患者的治疗时高血小板活性(PRI VASP >50%)发生率高于非肥胖患者(P<0.05)。在普拉格雷治疗者中,肥胖患者的治疗时低血小板活性(PRI VASP <20%)发生率低于非肥胖患者(P<0.001)。与之相应,非肥胖患者的出血并发症高于肥胖患者(P=0.03)。同时伴肥胖和MS患者的血小板活性显著高于其他肥胖患者。无MS肥胖患者的血小板活性与非肥胖患者无显著差异。


原文出处:

Pankert M, Quilici J, Loundou AD, Verdier V, Lambert M, Deharo P, Bonnet G, Gaborit B, Morange PE, Valéro R, Dutour A, Bonnet JL, Alessi MC, Cuisset T.Impact of Obesity and the Metabolic Syndrome on Response to Clopidogrel or Prasugrel and Bleeding Risk in Patients Treated After Coronary Stenting.Am J Cardiol. 2013 Oct 4. pii: S0002-9149(13)01928-0. doi: 10.1016/j.amjcard.2013.09.011.

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