The Effect Of Diabetes Mellitus On Antiplatelet Reactivity Of Clopidogrel In Patients With Coronary Heart Disease

Objective: Clear the diabetes mellitus of Coronary Heart Disease(Coronary Heart diseases,CHD)in patients with clopidogrel platelet reactivity.Selection methods: 99 patients with coronary heart disease who were hospitalized in People's Hospital of Xinjiang Uygur Autonomous Region from September 2015 to January 2018 were divided into diabetic group and non-diabetic group according to the presence or absence of diabetes mellitus.According to the level of glycosylated hemoglobin on admission,patients with diabetes mellitus A well-controlled subgroup of glycemic control(HbA1c<6.5%)and poor glycemic control subgroups(HbA1c ?6.5%).Subjects undergoing aspirin and clopidogrel antiplatelet therapy for more than 5 days,perfect thromboelastography to detect adenosine diphosphate(ADP)-induced platelet aggregation inhibition rate(IPA),maximum clot strength(MA),clotting reaction time(R)And hemagglutination mass formation rate(?).Results:(1)The IPA of diabetic group and non-diabetic group were(56.69 ± 28.54)vs(72.72 ± 24.09),P <0.05.The incidence of clopidogrel resistance were(40.4)vs(19.2),P <0.05.MA values were(44.05 ± 19.29)vs(27.55 ± 13.12)respectively,P <0.05.(2)The IPA values of subgroups with good glycemic control and poor glycemic control in diabetic group were(66.86 ± 24.22)vs(49.08 ±24.47),respectively,P <0.05.The incidence of clopidogrel resistance was(18.8)vs(51.6),P <0.05.MA values were(26.94 ± 17.44)vs(45.53 ± 19.97),P <0.05.(3)The R values of diabetic group and non-diabetic group were(5.01 ± 1.38)vs(5.49 ± 0.95),respectively,P<0.05.The values of ? were(67.86 ± 9.34)vs(65.78 ± 4.28),P <0.05 respectively.(4)The R values in subgroups with good glycemic control and poor glycemic control in diabetic group were(6.04 ± 1.62)vs(4.57 ± 0.97),respectively,P <0.05.The values of ?were(59.19 ± 12.6)vs(71.18 ± 3.81),P <0.05 respectively.Conclusion:(1)Diabetes affects the antiplatelet reactivity of clopidogrel in patients with coronary heart disease.Diabetes mellitus is more prone to clopidogrel resistance than nondiabetic patients.Patients with poor glycemic control in diabetes are more likely to have clopidogrel resistance than those with good glycemic control.(2)Diabetics have platelet function and increased coagulation activity.People with poor blood glucose control have stronger platelet function and clotting activity than those with good blood glucose control.