High platelet reactivity after P2Y12-inhibition in patients with atrial fibrillation and coronary stenting

High platelet reactivity (HPR) after P2Y 12 -inhibition in patients undergoing coronary stenting is associated with an increased risk for thromboembolic events and coronary death. So far it is not known how HPR affects the clinical outcome of different treatment strategies in patients with atrial fi...

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Published in:Journal of thrombosis and thrombolysis 2016-11, Vol.42 (4), p.558-565
Main Authors: Rilinger, Jonathan, Meyer, Melanie, Schnabel, Katharina, Weik, Patrick, Charlet, Anne, Esser, Jennifer S., Zhou, Qian, Bode, Christoph, Moser, Martin, Diehl, Philipp, Olivier, Christoph B.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Atrial Fibrillation - blood
Atrial Fibrillation - therapy
Blood Platelets - metabolism
Cardiology
Coronary Vessels
Drug Therapy, Combination
Female
Hematology
Humans
Male
Medicine
Medicine & Public Health
Platelet Activation - drug effects
Platelet Aggregation Inhibitors - administration & dosage
Receptors, Purinergic P2Y12
Risk Factors
Stents
Thromboembolism - blood
Thromboembolism - prevention & control
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Summary:High platelet reactivity (HPR) after P2Y 12 -inhibition in patients undergoing coronary stenting is associated with an increased risk for thromboembolic events and coronary death. So far it is not known how HPR affects the clinical outcome of different treatment strategies in patients with atrial fibrillation (AF) undergoing coronary stenting. In this single centre, observational study the antiplatelet effect of P2Y 12 -inhibitors in AF patients undergoing coronary stenting was investigated using impedance aggregometry. Patients received either dual antiplatelet therapy (DAPT) or triple therapy (TT). HPR was defined as the ratio of ADP-to TRAP-induced aggregation (r-ADP-agg) ≥50 %. Thromboembolic and bleeding events were assessed within the first 30 days after stenting. Out of 910 screened patients 167 patients were available for the present analysis. HPR was found in 5 of 43 (12 %) patients treated with DAPT and in 18 of 124 (15 %) patients treated with TT. In patients receiving TT, HPR was not a risk factor for thromboembolic events compared to patients with adequate response to P2Y 12 -inhibitors (6 vs. 8 %, p = 0.712). There was a trend for less bleeding events in patients with HPR compared to r-ADP-agg
ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-016-1397-5