Diabetes mellitus and carotid artery plaques exhibiting high-intensity signals on MR angiography are related to increased platelet reactivity after carotid artery stenting.
Diabetes mellitus and carotid artery plaques exhibiting high-intensity signals on MR angiography are related to increased platelet reactivity after carotid artery stenting.
复制标题
在MR血管造影上表现出高强度信号的糖尿病和颈动脉斑块与颈动脉支架后血小板反应性的增加有关。
DOI：
10.1136/neurintsurg-2016-012419
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发表时间：
2017-01
影响因子：
4.8
通讯作者：
Iwama T
中科院分区：
文献类型：
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作者：
Tsujimoto M;Enomoto Y;Kokuzawa J;Iwama T
颈动脉支架植入术（CAS）后血小板反应性增加可能导致血栓栓塞并发症。本研究的目的是调查CAS术后血小板反应性增加的发生率，并确定与之相关的因素。他们接受术前抗血小板治疗，包括阿司匹林（100 mg/天）、氯吡格雷（75 mg/天）和/或西洛他唑（200 mg/天）的某种组合，至少持续7天。 在CAS前和CAS后4天测量ADP和胶原诱导的血小板聚集。血小板反应性的变化报告为基于有效剂量50%的分类血小板反应性等级的变化。比较了血小板反应性升高和未升高患者的临床特征。在连续38例接受CAS的患者中，18例（47%）表现出血小板反应性增加。在多变量分析中，糖尿病（OR 15.0; 95% CI 2.1 - 106.5; p=0.007）和飞行时间MR血管造影（TOF-MRA）显示高强度信号（HIS）的颈动脉斑块（OR 25.2; 95% CI 2.0 - 316.2; p=0.013）与血小板反应性增加独立相关。近一半的CAS患者血小板反应性增加，与糖尿病和TOF-MRA显示HIS的颈动脉斑块独立相关。
Increased platelet reactivity after carotid artery stenting (CAS) may cause thromboembolic complications. This study aimed to investigate the incidence of increased platelet reactivity after CAS and to determine the factors related to it. Patients who underwent CAS were recruited prospectively. They received pre-procedural antiplatelet therapy comprising some combination of aspirin (100 mg/day), clopidogrel (75 mg/day), and/or cilostazol (200 mg/day) for a minimum of 7 days. ADP- and collagen-induced platelet aggregation were measured before and 4 days after CAS. Changes in platelet reactivity were reported as changes in the categorized platelet reactivity grade based on the effective dose 50%. Clinical characteristics of patients with and without increased platelet reactivity were compared. Among 38 consecutive patients who underwent CAS, 18 (47%) exhibited increased platelet reactivity. Diabetes mellitus (OR 15.0; 95% CI 2.1 to 106.5; p=0.007) and carotid artery plaques exhibiting high-intensity signals (HIS) on time-of-flight MR angiography (TOF-MRA) (OR 25.2; 95% CI 2.0 to 316.2; p=0.013) were independently associated with increased platelet reactivity in a multivariate analysis. Increased platelet reactivity occurred in nearly half of the studied patients subjected to CAS and was independently associated with diabetes mellitus and carotid artery plaques exhibiting HIS on TOF-MRA.
影响因子：
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作者：
Lee DH;Kim HS;Kim SM;Kwon SU;Suh DC
通讯作者：
Suh DC