Severe left ventricular systolic dysfunction is independently associated with high on-clopidogrel platelet reactivity
Jazyk angličtina Země Nový Zéland Médium print
Typ dokumentu časopisecké články, práce podpořená grantem
- MeSH
- akutní koronární syndrom epidemiologie MeSH
- cévní mozková příhoda epidemiologie MeSH
- dysfunkce levé srdeční komory farmakoterapie epidemiologie patofyziologie MeSH
- fosfoproteiny metabolismus MeSH
- inhibitory agregace trombocytů farmakologie terapeutické užití MeSH
- klopidogrel MeSH
- koronární angioplastika MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrofilamentové proteiny metabolismus MeSH
- molekuly buněčné adheze metabolismus MeSH
- retrospektivní studie MeSH
- senioři MeSH
- stenty MeSH
- tepový objem MeSH
- tiklopidin analogy a deriváty farmakologie terapeutické užití MeSH
- trombocyty metabolismus MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- fosfoproteiny MeSH
- inhibitory agregace trombocytů MeSH
- klopidogrel MeSH
- mikrofilamentové proteiny MeSH
- molekuly buněčné adheze MeSH
- tiklopidin MeSH
- Vasodilator-Stimulated Phosphoprotein MeSH
OBJECTIVE: The purpose of the present study was to investigate the association between left ventricular systolic function and the response to clopidogrel. METHODS: The efficacy of clopidogrel was measured by the vasodilator-stimulated phosphoprotein phosphorylation 20 ± 4 h after 600 mg of clopidogrel. High on-clopidogrel platelet reactivity (HCPR) was defined as a platelet reactivity index (PRI) ≥50%. The 30-day combined incidence of death, non-fatal acute coronary syndrome, re-percutaneous coronary intervention (PCI), stent thrombosis, and stroke was also investigated. RESULTS: The study group consisted of 519 patients undergoing PCI. The values (mean and 95% confidence interval) of the PRI were as follows: 40.4% (37.8-43.0) in patients with left ventricular ejection fraction (LVEF) >50%, 42.4% (39.3-45.6) in patients with LVEF 35-50%, and 46.7% (40.6-52.9) in patients with LVEF <35% (p = 0.013). The proportions of patients with HCPR were 35.9% in patients with LVEF ≥35 and 51.9% in patients with LVEF <35% (p = 0.022). After adjustment for variables that significantly influenced clopidogrel efficacy, LVEF <35% was found to be independently associated with HCPR (p = 0.039). The 30-day combined clinical endpoint occurred in 18% of patients with LVEF <35% and in 7.3% of patients with LVEF ≥35% (p = 0.026). The 30-day incidence of all-cause mortality was 14% in patients with LVEF <35 and 1.0% in patients with LVEF ≥35% (p < 0.001). CONCLUSION: An LVEF <35% was found to be independently associated with HCPR.
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