关键词: 抗血小板治疗高反应性,  , CYP2C19,  , 氯吡格雷,  , 非糖尿病患者

Abstract:

Objective Patients with clopidogrel high on⁃treatment platelet reactivity（HTPR）have a higher risk of recurrent vascular events. We attempted to explore risk factors associated with Clopidogrel HTPR in non⁃ diabetics. Methods A total of 1 822 non⁃diabetics with vascular events received clopidogrel were included. Maxi⁃ mum fibrin clot strength induced by ADP（MAADP）was identified by Thrombelastography，and CYP2C19 genotype was determined by DNA microarray. Results Clopidogrel HTPR was found in 13.2% of the patients（n = 241）. Multivariate analysis of logistic regression showed that gender，age，platelet distribution width（PDW），CYP2C19 were associated with Clopidogrel HTPR. The Clopidogrel HTPR predictive model had a good calibration by the Hosmer⁃Lemeshow goodness⁃of⁃fit test（P = 0.252），and the area under cure of ROC was 0.704（95%CI：0.670 ~ 0.738）. Conclusions Clopidogrel HTPR in non⁃diabetics was significantly influenced by gender，age，PDW and CYP2C19 polymorphisms. The predictive model of HTPR has a possibly helpful discrimination and good calibration.

Key words:

high on?treatment platelet reactivity, CYP2C19, clopidogrel, non?diabetics