Variabilityofplateletaggregationinpatientswithclopidogreltreatmentandhipfracture:Aretrospectivecase-controlstudyon112patients

摘要： AIM:Toidentifytherateofnon-responderstoclopidogreltreatmentinhipfracturepatientsandstudyhownon-respondersdifferfromcontrols.METHODS:Inaretrospectivecase-controlstudyweincluded28casesofacuteproximalfemoralfracturewithclopidogreltreatment2011to2013.Eighty-fourcontrolsfromthesametimeperiodwereincluded.Datacollectedincludedresponsetoclopidogrelmeasuredwithmultipleelectrodeaggregometry(MEA),intraoperativebleeding,erythrocytetransfusion,timetosurgeryandtheincidenceofadverseeventsupto3moaftersurgery.RESULTS:Eight(29%)ofthe28caseswerenonresponders.Themedianintraoperativebleedingwas300mL(range,0-1500),andwaslowerfornon-responders(50mL)butdidnotreachstatisticalsignificance.Erythrocytetransfusionsdidnotdifferbetweenresponders,non-respondersandcontrols.Forty-five(40%)of112patientshadadverseeventspostoperativelybuttheratedidnotdifferbetweenpatientswithandwithoutclopidogreltreatment.CONCLUSION:Almostone-thirdofpatientswithclopidogreltreatmentandanacuteproximalfemoralfracturearenon-responderstoantiplatelettherapyandcanbeoperatedwithoutdelay. ... （共7頁）