Change of Platelet Reactivity to Antiplatelet Therapy after Stenting Procedure for Cerebral Artery Stenosis: VerifyNow Antiplatelet Assay before and after Stenting.
Change of Platelet Reactivity to Antiplatelet Therapy after Stenting Procedure for Cerebral Artery Stenosis: VerifyNow Antiplatelet Assay before and after Stenting.
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DOI：
10.5469/neuroint.2012.7.1.23
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发表时间：
2012-02
影响因子：
--
通讯作者：
Suh DC
中科院分区：
文献类型：
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作者：
Lee DH;Kim HS;Kim SM;Kwon SU;Suh DC
VerifyNow抗血小板测定在各种脑动脉狭窄支架植入术前后进行，以确定手术本身对双重抗血小板功能的影响。共入组了30例接受脑动脉支架植入术的连续患者。抗血小板预处理方案为阿司匹林（每日100 mg）和氯吡格雷（负荷剂量300 mg，随后每日75 mg）。VerifyNow抗血小板测定在支架植入术前后进行。在阿司匹林反应单位（ARU）、P2 Y12反应单位（PRU）、基线（BASE）和抑制百分比方面比较两种检测结果。我们评价了任何术中支架内血栓形成或即刻血栓栓塞并发症的发生率，以及1个月随访时的缺血事件。ARU前的中位数为418（范围：350-586）。对于氯吡格雷，前BASE、PRU和抑制百分比的中位数分别为338（279-454）、256（56-325）和27%（0-57%）。支架植入后ARU、BASE、PRU和抑制百分比的中位数分别为469（范围：389-573）、378（288-453）、274（81-370）和26%（0-79%）。支架植入术前后ARU（p=0.045）、BASE（p=0.026）和PRU（p=0.018）显著增加。不良反应组在支架植入后观察到1例即刻血栓栓塞事件。随访1个月，无支架内血栓形成和缺血事件。我们观察到在各种脑动脉狭窄支架植入术后，血小板对双重抗血小板治疗的反应性显著增加。
VerifyNow antiplatelet assays were performed before and after stenting for various cerebral artery stenoses to determine the effect of the procedure itself to the function of dual antiplatelets given. A total of 30 consecutive patients underwent cerebral arterial stenting procedure were enrolled. The antiplatelet pretreatment regimen was aspirin (100 mg daily) and clopidogrel (300 mg of loading dose followed by 75mg daily). VerifyNow antiplatelet assay performed before and right after stenting. The two test results were compared in terms of aspirin-reaction unit (ARU), P2Y12 reaction units (PRU), baseline (BASE), and percentage inhibition. We evaluated occurrence of any intra-procedural in-stent thrombosis or immediate thromboembolic complication, and ischemic events in 1-month follow-up. The median Pre-ARU was 418 (range, 350-586). For clopidogrel the medians of the pre-BASE, PRU, and percent inhibition were 338 (279-454), 256 (56-325), and 27% (0-57%). The medians of the post-ARU, BASE, PRU, and percent inhibition after stenting were 469 (range, 389-573), 378 (288-453), 274 (81-370), and 26% (0-79%). There was a significant increase of ARU (p=0.045), BASE (p=0.026), and PRU (p=0.018) before and after stenting. One immediate thromboembolic event was observed in poor-response group after stenting. There was no in-stent thrombosis and ischemic event in 1-month follow-up. We observed a significant increase of platelet reactivity to dual antiplatelet therapy right after stenting procedure for various cerebral arterial stenoses.