Objective:To investigate the risk factors of clopidogrel resistance in young and middle-aged patients with acute coronary syndrome(ACS).Methods:A total of 111 ACS patients aged ≤ 60 years old admitted to the Cardiology Department of Sir Run Run Hospital,Nanjing Medical University from January 2022 to June 2023 were selected consecutively.The patients were divided into clopidogrel resistant(CR)and sensitive(CS)groups according to the platelet inhibition rate induced by the adenosine diphosphate(ADP)receptor pathway through TEG technology.The baseline characteristics and blood indicators were also collected.Logistic regression analysis and ROC curve were used to analyze the influencing factors of CR occurrence in young and middle-aged patients with ACS.Results:Triglyceride level of CR group was significantly higher that of CS group.The mean platelet volume(MPV),mean platelet volume/platelet count(MPV/PLT),mean platelet volume/plateletcrit(MPV/PCT),platelet distribution width/platelet count(PDW/PLT)of CR group were also significantly higher than those of CS group(P＜0.05).Multivariate logistic regression analysis identified triglyceride(OR=2.984,P=0.002)and MPV(OR=2.033,P=0.026)as risk factors associated with CR.The area under ROC curve of CR predicted by triglyceride combining with MPV was 0.798 with a sensitivity of 87.5％and a specificity of 62.0％.Conclusion:Triglyceride combined with MPV can be used as an effective predictor of CR in young and middle-aged patients with ACS,and provide guidance for clinical antithrombotic therapy.
维普
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