JAHA：血小板对ADP的高反应性可预测心血管疾病！

2018-03-03 xing.T MedSci原创

在以社区为基础的样本中，这些妇女均无心血管疾病和任何抗血小板治疗，对低剂量ADP的高反应与随访20期间未来的动脉血栓形成相关。这些发现支持ADP活化抑制作为一种重要的治疗手段，并鼓励进一步研究ADP抑制剂难治性人群。

血小板功能与心血管疾病（CVD）患者的不良事件相关。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，研究人员旨在通过FHS研究（Framingham心脏研究）来评估血小板功能与基于社区的心血管病事件之间的相关性。

参与者无心血管疾病，最近没有接受阿司匹林治疗。研究人员以胶原（1.9μμg/ml）、ADP（0.05-15μmol/L）和肾上腺素（0.01-15μmol/L）光透射法测定血小板功能，并用比例风险模型来分析血小板指标相关的结局发生情况（心肌梗塞/卒中、心血管病和心血管病死亡）。研究样本包括2831名参与者（平均年龄为54.3岁，57%为女性）。

随访期间（中位数为20.4年），研究人员观察到191次心肌梗死或卒中复合事件，432例CVD病例和117例CVD死亡。在多变量模型中，对ADP高反应性和ADP在1μmol/L时血小板聚集与心肌梗死和脑卒中事件显著相关（所有ADP剂量的高反应性风险比为1.68，95%可信区间[1.13-2.50]，P = 0.011；和风险比，ADP为1μmol/L的反应性最高四分位数与其他四分位数相比的风险比为1.16；95%可信区间为[1.02–1.33]，P = 0.029]）。没有观察到胶原延迟时间或任何肾上腺素指标与心肌梗死或卒中之间存在相关性。

在以社区为基础的样本中，这些妇女均无心血管疾病和任何抗血小板治疗，对低剂量ADP的高反应与随访20期间未来的动脉血栓形成相关。这些发现支持ADP活化抑制作为一种重要的治疗手段，并鼓励进一步研究ADP抑制剂难治性人群。

原始出处：

Marja K. Puurunen,et al. ADP Platelet Hyperreactivity Predicts Cardiovascular Disease in the FHS (Framingham Heart Study).JAHA.2018. https://doi.org/10.1161/JAHA.118.008522

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-08 xiaotao112411

学习学习学习

41 0
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createdTime=Thu Mar 08 10:21:04 CST 2018, time=2018-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294150, encodeId=9e0029415006, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Mar 08 10:20:58 CST 2018, time=2018-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294149, encodeId=12f429414970, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-08 xiaotao112411

学习学习学习

50 0
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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-08 xiaotao112411

学习学习学习

38 0
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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-05 changjiu

学习一下谢谢

19 0
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encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 05 13:47:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498378, encodeId=72f914983e826, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon Mar 05 13:47:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292874, encodeId=70a02928e493, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-05 zhaohui6731

#AHA#

26 0
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createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Mar 08 10:20:47 CST 2018, time=2018-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293271, encodeId=66062932e1a6, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Mar 05 18:08:30 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267753, encodeId=581d126e753fe, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 05 13:47:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498378, encodeId=72f914983e826, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon Mar 05 13:47:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292874, encodeId=70a02928e493, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-05 andy2090

#血管疾病#

19 0
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encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 05 13:47:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498378, encodeId=72f914983e826, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon Mar 05 13:47:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292874, encodeId=70a02928e493, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Mar 04 09:10:38 CST 2018, time=2018-03-04, status=1, ipAttribution=)]
2018-03-04 1209e435m98(暂无昵称)

学习了.谢谢分享

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