Impact of Anemia on Platelet Response to Clopidogrel in Patients Undergoing Percutaneous Coronary Stenting

• Published in: The American journal of cardiology 2012-04, Vol.109 (8), p.1148-1153
• Main Authors: Toma, Catalin, MD, Zahr, Firas, MD, Moguilanski, Diego, MD, Grate, Sheree, MS, Semaan, Roy W., MD, Lemieux, Nicole, MD, Lee, Joon S., MD, Cortese-Hassett, Andrea, PhD, Mulukutla, Suresh, MD, Rao, Sunil V., MD, Marroquin, Oscar C., MD
• Format: Article
• Language: English
• Subjects: Adenosine Diphosphate; Aged; Anemia; Anemia - blood; Anemias. Hemoglobinopathies; Angioplasty; Angioplasty, Balloon, Coronary; Biological and medical sciences; Blood platelets; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Coronary heart disease; Diseases of red blood cells; Female; Heart; Hematologic and hematopoietic diseases; Hemoglobin; Hemoglobins - analysis; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Platelet Aggregation - drug effects; Platelet Aggregation Inhibitors - therapeutic use; Platelet Function Tests - methods; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Stents; Ticlopidine - analogs & derivatives; Ticlopidine - therapeutic use
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2011.11.049

High residual platelet reactivity (HRPR) on clopidogrel is a predictor of recurrent ischemic events in patients undergoing percutaneous coronary interventions (PCI). Significant intraindividual variability in platelet aggregation on repeat testing has been reported. To understand factors contributing to the variability in platelet aggregation testing, we examined clinical and laboratory elements linked to HRPR in 255 consecutive patients tested ≥12 hours after PCI using light transmission aggregometry (LTA) in response to adenosine diphosphate 5 μmol/L and VerifyNow P2Y12 assay (VNP2Y12; Accumetrics). HRPR was defined as >46% residual aggregation for LTA and >236 P2Y12 response units (PRUs) for VNP2Y12. On multivariate analysis the only variable independently associated with HRPR with both LTA and VNP2Y12 was laboratory-defined anemia. Prevalences of HRPR by LTA were 34.3% in anemic patients, 15.6% in patients with normal hemoglobin levels, and 59.8% versus 25.9% by VNP2Y12 (p