Influential factors of clopidogrel resistance in patients with diabetes and coronary heart disease after percutaneous coronary intervention

Objectives To discuss the influential factors of clopidogrel resistance in patients with diabetes and coronary heart disease who received percutaneous coronary interventions(PCI). Methods A total of 159 coronary heart disease patients received PCI were enrolled(56 diabetic and 103 nondiabetic patients). Clopidogrel of 300 mg loading dose and75 mg / d ongoing dose was administered before and after PCI. The 5 μmol / L adenosine diphosphate(ADP)-induced maximum platelet aggregation rates(MPARs) were tested before administration as well as 24 h and 5 d after PCI. MPAR ≤10% was defiend as clopidogrel resistance. The basic clinical data, related routine examination results and PCI characteristics were compared between the two groups. Independent risk factors of clopidogrel resistance were explored by Logistic regression analysis. Results The ratio of clopidogrel resistance was much higher in diabetic patients than that in nondiabetic patients(48.2% vs. 20.4%, P0.05). There was no significant difference in basic clinical data and related routine examination results between the two groups(P0.05) except triglyceride which was obviously higher in diabetic patients(P 0.05). Logistic regression analysis revealed that history of diabetes was the independent risk factor of clopidogrel resistance in diabetic patients(β=0.243, OR=1.184, P=0.028). Conclusions Diabetic patients with coronary heart disease undergoing PCI have a higher ratio of clopidogrel resistance compared with nondiabetic patients. History of diabetes is the independent risk factor of clopidogrel resistance in diabetic patients with coronary heart disease after PCI.