Influential Factors Analysis Of Patients Undergoing Coronary Artery Stenting Complicated With High On-Treatment Platelet Reactivity

Objective: We are to investigate the incidence and influential factors of patients undergoing percutaneous coronary intervention(PCI)complicated with high on-treatment platelet reactivity after dual antiplatelet therapy.Methods:From July 2013 to July 2015,there were 334 patients with coronary heart disease(CHD)receiving PCI in the Cardiology of NO.9 People's Hospital Affiliated to Shanghai Jiaotong University.All patients were gived aspirin plus clopidogrel treatment.Thrombelastograph(TEG)was used to detect on-treatment platelet reactivity 48 hours after operation.LAR was defined as less than 50% arachidonic acid(AA)induced platelet inhibition,and NAR was more than 50% AA-induced platelet inhibition;LCR was defined as less than 30% diphosphate(ADP)induced platelet inhibition,and NCR was more than 50% ADP-induced platelet inhibition.The basic clinical data,related preoperative routine examination results and PCI characteristics were compared between LAR and NAR,LCR and NCR.Results: LAR occurred in 334 CHD patients(21.0%)after PCI.Logistic regression analysis showed diabetes(OR=1.86,95% CI:1.034-3.346,P=0.038)and platelet count(OR=1.007,95% CI:1.002-1.012,P=0.009)were probably an independent risk factors for LAR,ADP inhibition rate(OR=0.978,95% CI:0.968-0.989,P<0.001)was probably an independent protective factor for LAR.LCR occurred in 334 CHD patients(44.9%)after PCI.Logistic regression analysis showed AA inhibition rate(OR=0.978,95% CI:0.969-0.986,P<0.001)and creatinine level(OR=0.984,95% CI:0.973-0.994,P=0.003)were probably independent protective factors for LCR.Conclusions: Diabetes and high platelet count were probably an independent risk factors for LAR,High ADP inhibition rate was probably an independent protective factor for LAR.High AA inhibition rate were probably independent protective factors for LCR.