Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting: a single center, randomized, feasibility study

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	Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting: a single center, randomized, feasibility study
其他题名	Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting: a single center, randomized, feasibility study
	Zhu HongChang 1; Li Yi 2; Guan ShaoYi 2; Li Jing 2; Wang XiaoZeng 2; Jing QuanMin 2; Wang ZuLu 2; Han YaLing 2
	2015
发表期刊	JOURNAL OF GERIATRIC CARDIOLOGY
ISSN	1671-5411
卷号	12 期号:1 页码:23-29
摘要	Background Low responsiveness to clopidogrel (LRC) is associated with increased risk of ischemic events. This study was aimed to explore the feasibility of tailored antiplatelet therapy according to the responsiveness to clopidogrel. Methods A total of 305 clopidogrel naive patients with acute coronary syndromes (ACS) undergoing coronary stenting were randomly assigned to receive standard (n = 151) or tailored (n = 154) antiplatelet therapy. The ADP-induced platelet aggregation tests by light transmission aggregometry were performed to identify LRC patients assigned to the tailored group. The standard antiplatelet regimen was dual antiplatelet therapy with aspirin and clopidogrel. The tailored antiplatelet therapy was standard regimen for non-LRC patients and an additional 6-month cilostazol treatment for LRC patients. The primary efficacy outcome was the composite of cardiovascular death, myocardial infarction or stroke at one year. Results LCR was present in 26.6% (41/154) of patients in the tailored group. The percentage platelet aggregation for LCR patients was significantly decreased at three days after adjunctive cilostazol treatment (77.5% +/- 12.1% vs. 64.5% +/- 12.1%, P < 0.001). At one year follow-up, a non-significant 37% relative risk reduction of primary events were observed in the tailored group as compared to the standard group (5.8% vs. 9.3%, P = 0.257). There were no differences in the rates of stent thrombosis and hemorrhagic events between the two groups. Conclusions Tailored antiplatelet therapy for ACS patients after coronary stenting according to responsiveness to clopidogrel is feasible. However, its efficacy and safety need further confirmation by clinical trials with larger sample sizes.
其他摘要	Background Low responsiveness to clopidogrel (LRC) is associated with increased risk of ischemic events. This study was aimed to explore the feasibility of tailored antiplatelet therapy according to the responsiveness to clopidogrel. Methods A total of 305 clopidogrel naive patients with acute coronary syndromes (ACS) undergoing coronary stenting were randomly assigned to receive standard (n = 151) or tailored (n = 154) antiplatelet therapy. The ADP-induced platelet aggregation tests by light transmission aggregometry were performed to identify LRC patients assigned to the tailored group. The standard antiplatelet regimen was dual antiplatelet therapy with aspirin and clopidogrel. The tailored antiplatelet therapy was standard regimen for non-LRC patients and an additional 6-month cilostazol treatment for LRC patients. The primary efficacy outcome was the composite of cardiovascular death, myocardial infarction or stroke at one year. Results LCR was present in 26.6% (41/154) of patients in the tailored group. The percentage platelet aggregation for LCR patients was significantly decreased at three days after adjunctive cilostazol treatment (77.5% ± 12.1% vs. 64.5% ± 12.1%, P < 0.001). At one year follow-up, a non-significant 37% relative risk reduction of primary events were observed in the tailored group as compared to the standard group (5.8% vs. 9.3%, P = 0.257). There were no differences in the rates of stent thrombosis and hemorrhagic events between the two groups. Conclusions Tailored antiplatelet therapy for ACS patients after coronary stenting according to responsiveness to clopidogrel is feasible. However, its efficacy and safety need further confirmation by clinical trials with larger sample sizes.
关键词	PATIENTS SHOWING RESISTANCE ASPIRIN AND/OR RESISTANCE CARDIOVASCULAR EVENTS MYOCARDIAL-INFARCTION CLOPIDOGREL RESISTANCE RESPONSE VARIABILITY PLATELET INHIBITION DRUG-RESISTANCE INCREASED RISK INTERVENTION Acute coronary syndrome Antiplatelet therapy Clopidogrel Coronary stenting
收录类别	CSCD
语种	英语
资助项目	[National Key Technology R&D Program in the 12th Five-year Plan of China]
CSCD记录号	CSCD:5333421
引用统计
文献类型	期刊论文
条目标识符	http://ir.imr.ac.cn/handle/321006/148942
专题	中国科学院金属研究所
作者单位	1.Dalian Med University, Affiliated Hosp 2, Dalian 116023, Shandong, Peoples R China 2.中国科学院金属研究所
推荐引用方式 GB/T 7714	Zhu HongChang,Li Yi,Guan ShaoYi,et al. Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting: a single center, randomized, feasibility study[J]. JOURNAL OF GERIATRIC CARDIOLOGY,2015,12(1):23-29.
APA	Zhu HongChang.,Li Yi.,Guan ShaoYi.,Li Jing.,Wang XiaoZeng.,...&Han YaLing.(2015).Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting: a single center, randomized, feasibility study.JOURNAL OF GERIATRIC CARDIOLOGY,12(1),23-29.
MLA	Zhu HongChang,et al."Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting: a single center, randomized, feasibility study".JOURNAL OF GERIATRIC CARDIOLOGY 12.1(2015):23-29.