Correlation Between Glycosylated Hemoglobin Level and Clopidogrel Resistance in Patients with Coronary Heart Disease Complicated with Type 2 Diabetes Mellitus after Elective PCI
Objective:To investigate the correlation between the level of hemoglobin A1c(HbA1c) and clopidogrel resistance in patients with coronary heart disease(CHD) and type 2 diabetes mellitus(T2DM) after elective coronary intervention(PCI).Methods:A total of 108 patients with CHD and T2DM,ranging in age from 40 to 75 years old,who underwent elective PCI in the Department of Cardiology of our hospital from June 2020 to June 2023,were retrospectively selected and divided into clopidogrel resistance group(45 cases) and clopidogrel sensitive group(63 cases).General data,HbA1c index,and other related data were collected,and SPSS 23.0 statistical software was used for statistical analysis.Spearman correlation analysis was used to investigate the relationship between HbA1c and other risk factors affecting clopidogrel resistance in CHD patients with T2DM after PCI.Multivariate Logistic regression models were used to analyze the independent association between HbA1c levels and the risk of clopidogrel resistance. The factors influencing clopidogrel resistance in CHD patients with T2DM after PCI were analyzed in subgroups. The relationship between clopidogrel resistance in T2DM patients with HbA1c and CHD after PCI was analyzed by restricted cubic spline method combined with Logistic regression.Results:Comparing the general data of the two groups of patients showed:that the levels of HbA1c,duration of diabetes,fasting plasma glucose(FPG),C-reactive protein(CRP),triglyceride(TG),and cardiac troponin I(cTnI) in clopidogrel resistant group were significantly higher than those in clopidogrel sensitive group(P<0.01).There were no significant differences in platelets(PLT),red blood cell(RBC),and white blood cell(WBC).Spearman correlation analysis was used to analyze the relationship between HbA1c and other risk factors affecting clopidogrel resistance in CHD patients with T2DM after PCI.The results showed that duration of diabetes,FPG,CRP,TG,cTnI were positively correlated with HbA1c(P<0.001).Multivariate Logistic regression model analysis showed that HbA1c level was independently correlated with the risk of clopidogrel resistance(P<0.001).Subgroup analysis was performed for indicators affecting clopidogrel resistance in CHD patients with T2DM after PCI according to clinical significance or median tangential point.The results showed that in duration of diabetes,FPG,TG,and cTnI subgroups,the correlation between HbA1c and clopidogrel resistance in T2DM patients with CHD after PCI remained stable,and there was no interaction between the subgroups(P interaction>0.05).There was no significant correlation in CRP subgroup(P>0.05) and no significant interaction(P>0.05).Restricted cubic spline method combined with Logistic regression was used to analyze the relationship between HbA1c and clopidogrel resistance in CHD patients with T2DM after PCI.There was a nonlinear dose-response relationship between HbA1c and clopidogrel resistance after PCI inT2DM patients with CHD(P<0.05),and there was a positive correlation.Conclusion:The level of HbA1c in clopidogrel resistance group after CHD combined with T2DM elective PCI was significantly higher than that in clopidogrel sensitive group,and there was an independent and positive correlation between HbA1c level and clopidogrel resistance in CHD combined with T2DM patients after PCI.
万方数据
维普
