Changes and Significance of PTS Molecular Markers after Treatment of Clopidogrel in Coronary Heart Disease Patients Combined with Diabetes

Abstract：Objective To observe the changes and significance of prethrombotic state(PTS)molecular markers after treatment of clopidogrel in coronary heart disease(CHD)patients combined with non - insulin dependent diabetes mellitus(NIDDM). Methods PTS molecular markers were measured in 36 patients with stable angina(SA),38 pa-tients with unstable angina(UA),40 UA patients combined with NIDDM,who were given platelet ADP receptor antag-onist clopidogrel 75 mg/ d. PTS molecular markers were reexamined and clopidogrel resistance was measured 10 days later. Results ①There were more obvious changes of PTS molecular markers in patients with UA,especially in those combined with NIDDM before clopidogrel treatment. ②There were significant improvement of PTS molecular markers in patients in three groups after clopidogrel treatment. ③There were 18 cases with clopidogrel resistance and 96 cases without clopidogrel resistance in 114 cases. There were significant improvement of PTS in patients without clopidogrel resistance. However,there was no significant difference of PTS molecular markers before and after treatment in patients with clopidogrel resistance. Conclusion PTS in CHD patients combined with diabetes is more serious than CHD pa-tients without diabetes. PTS in patients with UA is more serious than that in patients with SA. PTS in patients with all types of CHD can be intervened by clopidogrel therapy. However,it is not effective in patients with clopidogrel resist-ance,which may be an important cause of poor prognosis in these patients.