Clinical application of VerifyNow-P2Y12 assay in evaluation of platelet inhibition efficacy of clopidogrel / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the platelet inhibition efficacy in patients under regular maintenance dose of clopidogrel by VerifyNow-P2Y12 assay and explore the clinical characteristics of clopidogrel non-responders and related predicting factors.</p><p><b>METHODS</b>A total of 99 patients underwent percutaneous coronary intervention procedure and receiving clopidogrel in regular maintenance dose for at least 1 week were enrolled. Platelet reactivity, including baseline, P2Y12 reaction unit (PRU), and platelet inhibition rate were measured with VeifyNow-P2Y12 assay. The dosage of anti-platelet drugs, combination with any other drugs, clinical characters in baseline of all enrolled patients were analyzed. PRU ≤ 240 was used as cut-off to identify clopidogrel responder and clopidogrel non-responder. In the non-responder group, patients were further separated into 3 sub-groups (types) according to the baseline and platelet inhibition rate: type I with high baseline, high inhibition rate, representing false non-responder; type II with low inhibition rate, representing true non-responder and type III mixed type.</p><p><b>RESULTS</b>In this study, 48 of 99 patients were found to be clopidogrel non-responder (48.5%). The ratio of type I, type II and type III in the non-responder group was 9.1% (n = 9), 27.3% (n = 27), and 12.1% (n = 12), respectively. Baseline platelet value in female patients was significantly higher than in males (P < 0.01), number of females with high PRU also is higher than males (P < 0.01), female gender was a predict factor for type I non-responder (OR = 6.5, 95%CI 2.295 - 18.407, P < 0.01). BMI > 24 kg/m(2) was a risk factor for clopidogrel non-responder (P < 0.05), and may be regarded as a predict factor for type II non-responder (OR = 3.207, 95%CI 1.375 - 7.485, P < 0.01). Age, hypertension, diabetics, smoking, hyperlipidemia, CRP and pantoprazole use do not show significant correlation with baseline and platelet inhibition rate.</p><p><b>CONCLUSIONS</b>Clopidogrel responses could be reliably detected by VerifyNow-P2Y12 assay. Female gender and high body weight are independent risk factors for clopidogrel non-responses.</p>

Developing an environmental indicator system for sustainable development in China: Two case studies of selected indicators.

Environmental indicator systems are a fundamental tool in quantifying the environmental component of sustainable development. They are useful because they quantify the status and trends of key environmental parameters and provide information on the environment that allows authorities and communities to make informed decisions. This article analyzes the basic framework for Chinese environmental indicator systems and presents a "core" set of environmental indicators. In our research, we used a theme approach to develop the environmental indicator systems. We performed two case studies of selected indicators. In the first, we used an urban ambient air pollution composite index and an urban ambient air pollution indicator for three main pollutants to examine trends in urban air pollution in China from 1990 to 2000 at regional and national levels. The results indicate that China has made some progress towards controlling urban air pollution, but must do more in order to reach acceptable pollution levels. We think that an aggregated index and disaggregated indicators have important complementary roles in the policy-making processes. In the second case study, we developed and constructed a grassland degradation index that aggregates information on the extent and severity of grassland degradation. Taking the Xilinhaote region of Inner Mongolia as the study area, we calculated this index by combining remote-sensing data, a geographical information system (GIS), and field investigation. Based on these results, we provide recommendations regarding further development and measurement of environmental indicators in China.