Observational Study of Platelet Reactivity in Patients Presenting With ST-Segment Elevation Myocardial Infarction Due to Coronary Stent Thrombosis Undergoing Primary Percutaneous Coronary Intervention: Results From the European PREvention of Stent Thrombosis by an Interdisciplinary Global European Effort Registry

. 2017 Dec 26 ; 10 (24) : 2548-2556.

Jazyk angličtina Země Spojené státy americké Médium print

Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie, pozorovací studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid29268884
Odkazy

PubMed 29268884
DOI 10.1016/j.jcin.2017.09.019
PII: S1936-8798(17)31985-4
Knihovny.cz E-zdroje

OBJECTIVES: High platelet reactivity (HPR) was studied in patients presenting with ST-segment elevation myocardial infarction (STEMI) due to stent thrombosis (ST) undergoing immediate percutaneous coronary intervention (PCI). BACKGROUND: HPR on P2Y12 inhibitors (HPR-ADP) is frequently observed in stable patients who have experienced ST. The HPR rates in patients presenting with ST for immediate PCI are unknown. METHODS: Consecutive patients presenting with definite ST were included in a multicenter ST registry. Platelet reactivity was measured before immediate PCI with the VerifyNow P2Y12 or Aspirin assay. RESULTS: Platelet reactivity was measured in 129 ST patients presenting with STEMI undergoing immediate PCI. HPR-ADP was observed in 76% of the patients, and HPR on aspirin (HPR-AA) was observed in 13% of the patients. HPR rates were similar in patients who were on maintenance P2Y12 inhibitor or aspirin since stent placement versus those without these medications. In addition, HPR-ADP was similar in patients loaded with a P2Y12 inhibitor shortly before immediate PCI versus those who were not. In contrast, HPR-AA trended to be lower in patients loaded with aspirin as compared with those not loaded. CONCLUSIONS: Approximately 3 out of 4 ST patients with STEMI undergoing immediate PCI had HPR-ADP, and 13% had HPR-AA. Whether patients were on maintenance antiplatelet therapy while developing ST or loaded with P2Y12 inhibitors shortly before undergoing immediate PCI had no influence on the HPR rates. This raises concerns that the majority of patients with ST have suboptimal platelet inhibition undergoing immediate PCI.

2nd Department of Cardiology University Hospital Krakow Poland

Amsterdam Medical Centre Department of Cardiology Amsterdam the Netherlands

Cardiac Department Hospital Universitario de La Princesa Madrid Spain

Coronary Research Group University Hospital Southampton Southampton United Kingdom

Department of Cardiology and Angiology 2 Universitäts Herzzentrum Freiburg Bad Krozingen Germany

Department of Cardiology International Clinical Research Center St Anne Hospital and Masaryk University Brno Czech Republic

Department of Cardiology St Antonius Hospital Nieuwegein the Netherlands

Department of Cardiology University Hospitals Leuven and Department of Cardiovascular Sciences KU Leuven Belgium

Department of Cardiology Ziekenhuis Oost Limburg Genk Belgium

Department of Cardiovascular Sciences University of Leicester and NIHR Cardiovascular Biomedical Research Centre University Hospitals of Leicester Leicester United Kingdom

Deutsches Herzzentrum München Technische Universität München Munich Germany

Deutsches Herzzentrum München Technische Universität München Munich Germany; DZHK partner site Munich Heart Alliance Munich Germany

DZHK partner site Munich Heart Alliance Munich Germany; Medizinische Klinik und Poliklinik 1 Ludwig Maximilians Universität Munich Germany

Freeman Hospital and Institute of Cellular Medicine Newcastle University Newcastle upon Tyne United Kingdom

French Alliance for Cardiovascular Trials DHU FIRE INSERM U 1148 Hôpital Bichat AP HP and Université Paris Diderot Sorbonne Paris Cité Paris France

French Alliance for Cardiovascular Trials DHU FIRE INSERM U 1148 Hôpital Bichat AP HP and Université Paris Diderot Sorbonne Paris Cité Paris France; National Heart and Lung Institute Royal Brompton Hospital Imperial College London United Kingdom

Institute of Cardiology Jagiellonian University Medical College Kraków Poland

Interventional Cardiology Division Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy

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