VerifyNow和Multiplate两种血小板功能检测方法对急性冠脉综合征患者的预测价值

摘要

Objective To investigate the predictive value of two methods of platelet function detection for VerifyNow and Multiplate in patients with acute coronary syndrome (ACS).Methods Verify Now and Multiplate were used to detect the platelet reactivity of patients with ACS.The relationship between platelet reactivity and major adverse cardiovascular events (MACE)was explored,including all-cause death,non fatal myocardial infarction,non fatal stroke,stent thrombosis and revascularization.Results After one year of follow-up for 120 patients with ACS, 18 patients (15%)had MACE.The platelet reactivity detected by the two methods was both associated with MACE. Logistic regression analysis found that only VerifyNow could predict the occurrence of MACE (P =0.01).VerifyNow detection showed that the incidence of MACE in patients with high platelet response (HPR)was 16%,and the incidence of MACE without HPR was 7% (OR =2.6,95% CI =1.5-4.4,P =0.001).The incidence of MACE in patients with HPR was 13%,and the incidence of MACE without HPR was 9% (OR =1.5,95% CI =0.9-2.5,P =0.11)without HPR.Conclusion This study demonstrated VerifyNow could predict the adverse outcomes better in patients with ACS than Multiplate.%目的 探讨两种快速床旁检测血小板功能的方法Multiplate和VerifyNow技术对急性冠脉综合征(ACS)患者不良心血管事件的预测价值.方法 分别应用VerifyNow和Multiplate技术检测ACS患者的血小板反应性,探讨血小板反应性与主要不良心血管事件(MACE,由全因死亡、非致死性心肌梗死、非致死性卒中、支架内血栓形成和血运重建组成的复合终点)之间的关系.结果 对120例ACS患者随访1年后,MACE 18例(15%).两种方法检测的血小板反应性均与MACE相关.Logistic回归分析发现,只有VerifyNow可以预测MACE的发生(P=0.01).VerifyNow检测显示为血小板高反应(HPR)的患者MACE发生率为16%,没有HPR的患者MACE发生率为7%(OR=2.6,95%CI=1.5~4.4,P=0.001).Multiplate检测显示为HPR的患者MACE发生率为13%,没有HPR的MACE发生率为9%(OR=1.5,95%CI=0.9~2.5,P=0.11).结论 VerifyNow技术检测血小板功能比Multiplate技术可以更好地预测ACS患者的不良预后.