Platelet Reactivity and Cardiovascular Outcomes After Percutaneous Coronary Intervention: A Time-Dependent Analysis of the Gauging Responsiveness With a VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) Trial

In the Gauging Responsiveness With A VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial, 6 months of high-dose clopidogrel did not reduce cardiovascular events compared with standard-dose clopidogrel in patients with high on-treatment platelet reactivity (OTR) after percutaneous...

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Published in:Circulation (New York, N.Y.) N.Y.), 2011-09, Vol.124 (10), p.1132-1137
Main Authors: PRICE, Matthew J, ANGIOLILLO, Dominick J, TEIRSTEIN, Paul S, LILLIE, Elizabeth, MANOUKIAN, Steven V, BERGER, Peter B, TANGUAY, Jean-François, CANNON, Christopher P, TOPOL, Eric J
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - drug therapy
Aged
Biological and medical sciences
Blood and lymphatic vessels
Blood Platelets - drug effects
Cardiology. Vascular system
Coronary heart disease
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Drug-Eluting Stents
Female
Follow-Up Studies
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - drug therapy
Myocardial Infarction - mortality
Myocardial Infarction - prevention & control
Platelet Aggregation Inhibitors - therapeutic use
Platelet Function Tests
Thrombosis - drug therapy
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
Treatment Outcome
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Summary:In the Gauging Responsiveness With A VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial, 6 months of high-dose clopidogrel did not reduce cardiovascular events compared with standard-dose clopidogrel in patients with high on-treatment platelet reactivity (OTR) after percutaneous coronary intervention, defined as OTR ≥230 P2Y12 reaction units according to the VerifyNow P2Y12 platelet function test. The aim of this analysis was to examine the relationship between outcomes and OTR over the course of the trial. OTR was measured at 12 to 24 hours and 30±7 days after percutaneous coronary intervention. Cox proportional hazards models with OTR as a time-varying covariate were used to determine the association between OTR and the primary end point of cardiovascular death, myocardial infarction, and stent thrombosis. Of the 2800 enrolled patients, 2796 (99.98%) had evaluable platelet function data. OTR
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.111.029165