High on Treatment Platelet Reactivity and Stent Thrombosis

Background Stent thrombosis (ST) remains a major adverse outcome of percutaneous coronary intervention (PCI). We examined potential associations between high on treatment platelet reactivity and the risk of ST and assessed the effects of increased antiplatelet dosage on platelet inhibition. Methods...

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Published in:Heart, lung & circulation lung & circulation, 2011-08, Vol.20 (8), p.525-531
Main Authors: Rajendran, Saissan, Parikh, Devang, MBBS, Shugman, Ibrahim, MB BCh, French, John K., MB ChB MSc PhD, Juergens, Craig P., MBBS
Format: Article
Language:English
Subjects:
Adult
Aged
Angioplasty
Antiplatelet
Aspirin
Aspirin - administration & dosage
Cardiovascular
Clopidogrel
Coronary Artery Disease - therapy
Female
Humans
Hyporesponsiveness
Male
Middle Aged
Platelet Activation - drug effects
Platelet Aggregation Inhibitors - administration & dosage
Stent thrombosis
Stents - adverse effects
Thrombosis - blood
Thrombosis - etiology
Thrombosis - prevention & control
Ticlopidine - administration & dosage
Ticlopidine - analogs & derivatives
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Summary:Background Stent thrombosis (ST) remains a major adverse outcome of percutaneous coronary intervention (PCI). We examined potential associations between high on treatment platelet reactivity and the risk of ST and assessed the effects of increased antiplatelet dosage on platelet inhibition. Methods Differences in clinical characteristics and the effect of aspirin and clopidogrel on platelet reactivity were determined after angiographically proven ST in 16 patients and in 40 patients without ST. Platelet reactivity was determined using the VerifyNow assays (Accumetrics Inc., San Diego, CA). Patients found with high on treatment platelet reactivity (P2Y12 Reaction Units ≥ 235 and/or Aspirin Reaction Units ≥ 550) returned following two weeks of double dose antiplatelet therapy for further analyses. Results High post aspirin and/or clopidogrel platelet reactivity was significantly more common in patients with ST versus controls (75% vs. 2.5%, p =
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2011.04.004