Objective To observe the serum levels of inflammatory cytokines in patients with clopidogrel resistance underwent PCI.
Methods Platelet aggregation (PAG) induced with ADP were detected in 593 patients with unstable angina pectoris and had received coronary stenting. All patients were divided into clopidogrel resistance (CLR) group (n=333) and normal response group (n=260) according to PAG. At the same time, perpheral blood sample of all the patients were taken before, 24 h, 1 week and 1 month after implanting stents. The levels of C-reactive protein (CRP), P-selection and soluble fragment of CD40 ligand (sCD40L) in these patients were detected by enzyme linked immunosorbent assay.
Results The incidence of clopidogrel resistance in 24 h, 1 week and 1 month after PCI was 35.5%, 26.9% and 19.3%. The levels of CRP (8.8±2.5 mg/dl at 24 h, 5.3±2.5 mg/dl at 1 week), P-selection (73.8±34 ng/ml at 24 h, 70.5±31.6 ng/ml at 1 week and 66.4±22.3 ng/ml at 1 month) and sCD40L (7.7±2.3 ng/ml at 24 h)had significant difference compared with the levels before and normal group (p<0.05). The CLR at 30 days after stent implanting was significantly correlated with the level of P-selection (r=1.334) and smoking (r=1.053).
Conclusion The levels of CRP, P-selection and sCD40L of in some patient after undergoing coronary stenting increased and may correlated with clopidogrel resistance. The levels of P-selection and smoking were the predictor for clopidogrel resistance.