| Impact of serum lipid level on residual platelet reactivity in patients with non-ST elevation acute coronary syndrome receiving dual anti-platelet therapy after percutaneous coronary intervention |
| Received:May 01, 2022 Revised:September 24, 2022 Click here to download the full text |
| Citation of this paper:QIU Qi-ning,LI Xiao-ye,CHEN Qing-xing,YE Yan-rong.Impact of serum lipid level on residual platelet reactivity in patients with non-ST elevation acute coronary syndrome receiving dual anti-platelet therapy after percutaneous coronary intervention[J].Chinese Journal of Clinical Medicine,2023,30(2):306-311 |
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| Author Name | Affiliation | E-mail | | QIU Qi-ning | Department of Pharmacy, Zhongshan Hospital, Fudan University(Xiamen Branch), Xiamen 361015, Fujian, China
Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | LI Xiao-ye | Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | CHEN Qing-xing | Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | YE Yan-rong | Department of Pharmacy, Zhongshan Hospital, Fudan University(Xiamen Branch), Xiamen 361015, Fujian, China
Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China | ye.yanrong@zs-hospital.sh.cn |
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| Abstract:Objective To explore the impact of lipid level on the platelet function of patients with non-ST elevation acute coronary syndrome (NSTE-ACS) receiving aspirin and clopidogrel after drug-eluting stents implantation. Methods A total of 335 NSTE-ACS patients underwent percutaneous coronary intervention (PCI) in Zhongshan Hospital, Fudan University from February 2017 to December 2017 were included prospectively. All patients took orally loading dose of aspirin 300 mg and clopidogrel 300 mg before PCI and maintenance dose of aspirin 100 mg and clopidogrel 75 mg after PCI. Thrombelastography were performed on the third day after PCI, and adenosine diphosphate-induced platelet-fibrin clot strength (MAADP)＞47 mm was defined as a high-residual platelet reactivity (HRPR). There were 71 patients and 264 patients in the HRPR and non-HRPR groups, respectively. The impact of lipid indexes on platelet reactivity was analyzed by Pearson correlation analysis and multivariate analysis. Kaplan-Meiern survival curve was used to compare ischemic major adverse cardiac event rates among HRPR and non-HRPR groups with different lipid levels. Results Pearson correlation analysis showed that both total cholesterol (r＝0.256, P＜0.001) and low-density lipoprotein cholesterol (LDL-C) levels (r＝0.284, P＜0.001) were positively correlated with MAADP. The multivariate regression analysis showed that LDL-C was the independent risk factor contributing to HRPR (OR＝2.209, 95%CI 1.591-3.066, P＜0.001). The occurrence of ischemic major adverse cardiac events in HRPR with LDL-C≥2.6 mmol/L patients was significantly higher (P＜ 0.05). Conclusions For NSTE-ACS patients receiving dual anti-platelet therapy after PCI, LDL-C elevating may result in HRPR and increased ischemic events, which indicates that the dual anti-platelet therapy should be prolonged. |
| keywords:aspirin clopidogrel thrombelastography platelet low-density lipoprotein cholesterol |
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