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 responsivene...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.展开更多
The acute （15 minutes-4 hours） effects of exposure to the inhaled DEE （diesel exhaust emitted） on blood parameters of Guinea pigs Cavia porcellus were assessed via CBC （complete blood count） as an indicator usin...The acute （15 minutes-4 hours） effects of exposure to the inhaled DEE （diesel exhaust emitted） on blood parameters of Guinea pigs Cavia porcellus were assessed via CBC （complete blood count） as an indicator using an automated blood analyzer machines （Cell DYN 1700）. The results showed significant changes in some parameters in comparison with control animals started as early as 15 minutes and intensified by the continuous exposure time, leading to significant increase （p 〈 0.05） in the number of both WBC （white blood cells）, PLT （blood platelets） and decrease in numbers of RBC （red blood corpuscles） while hemoglobin percentages （Hb%） showed an insignificant （p 〉 0.05） fluctuating rhythm. The percentages of both Neutrophil and Lymphocyt recorded a significant increase （p 〈 0.05） 1 hour post-exposure to the DEE while other WBCs showed less changes. It is concluded that blood components are so sensitive to DEE and do respond quicker to inhaled pollutants via changes in some components of WBC% but decrease in RBC% and the likelihood of blood clotting due to increase in blood platelets. These results indicate the acute toxic risks of the exposure to DEE of mechanics and technicians who work in vicinity of DEE sources or/and spend most daily hours in semi closed areas.展开更多
文摘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.
文摘The acute （15 minutes-4 hours） effects of exposure to the inhaled DEE （diesel exhaust emitted） on blood parameters of Guinea pigs Cavia porcellus were assessed via CBC （complete blood count） as an indicator using an automated blood analyzer machines （Cell DYN 1700）. The results showed significant changes in some parameters in comparison with control animals started as early as 15 minutes and intensified by the continuous exposure time, leading to significant increase （p 〈 0.05） in the number of both WBC （white blood cells）, PLT （blood platelets） and decrease in numbers of RBC （red blood corpuscles） while hemoglobin percentages （Hb%） showed an insignificant （p 〉 0.05） fluctuating rhythm. The percentages of both Neutrophil and Lymphocyt recorded a significant increase （p 〈 0.05） 1 hour post-exposure to the DEE while other WBCs showed less changes. It is concluded that blood components are so sensitive to DEE and do respond quicker to inhaled pollutants via changes in some components of WBC% but decrease in RBC% and the likelihood of blood clotting due to increase in blood platelets. These results indicate the acute toxic risks of the exposure to DEE of mechanics and technicians who work in vicinity of DEE sources or/and spend most daily hours in semi closed areas.
