Clinical outcomes and predictive model of platelet reactivity to clopidogrel after acute ischemic vascular events

摘要: Background: High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease. We explored predictive model of to clopidogrel and the relationship clinical outcomes. Methods: A total 441 were included. Platelet was measured by light transmittance aggregometry after receiving dual antiplatelet therapy. HTPR defined consensus cutoff maximal aggregation >46% aggregometry. CYP2C19 loss-of-function polymorphisms identified DNA microarray analysis. The data compared binary logistic regression find factors. primary endpoint major adverse events (MACEs), followed median time 29 months. Survival curves constructed Kaplan-Meier estimates logrank tests between non-HTPR. Results: The rate 17.2%. Logistic following predictors HTPR: age, therapy regimen, body mass index, diabetes history, CYP2C19*2, or CYP2C19*3 variant. area under curve receiver operating characteristic 0.793 (95% confidence interval: 0.738–0.848). analysis showed that had higher incidence MACE than those non-HTPR (21.1% vs. 9.9%; χ2 = 7.572, P 0.010). Conclusions: Our results suggest advanced treatment regular therapy, diabetes, CYP2C19*2 carriers are significantly associated clopidogrel. useful discrimination good calibration may predict long-term MACE. Key words: High reactivity; Clopidogrel; CYP2C19; Light aggregometry; Ischemic