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
Jazyk angličtina Země Spojené státy americké Médium print
Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie, pozorovací studie, práce podpořená grantem
PubMed
29268884
DOI
10.1016/j.jcin.2017.09.019
PII: S1936-8798(17)31985-4
Knihovny.cz E-zdroje
- Klíčová slova
- P2Y(12) receptor antagonists, aspirin, platelet aggregation, platelet function tests, stent thrombosis,
- MeSH
- adenosindifosfát krev MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- infarkt myokardu s elevacemi ST úseků krev diagnostické zobrazování etiologie chirurgie MeSH
- inhibitory agregace trombocytů škodlivé účinky terapeutické užití MeSH
- koronární angioplastika škodlivé účinky přístrojové vybavení MeSH
- koronární trombóza krev diagnostické zobrazování etiologie prevence a kontrola MeSH
- léková rezistence MeSH
- lidé středního věku MeSH
- lidé MeSH
- purinergní receptory P2Y - antagonisté škodlivé účinky terapeutické užití MeSH
- purinergní receptory P2Y12 krev účinky léků MeSH
- recidiva MeSH
- registrace MeSH
- rizikové faktory MeSH
- senioři MeSH
- stenty škodlivé účinky MeSH
- trombocyty účinky léků metabolismus MeSH
- vyšetření funkce trombocytů MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- adenosindifosfát MeSH
- biologické markery MeSH
- inhibitory agregace trombocytů MeSH
- P2RY12 protein, human MeSH Prohlížeč
- purinergní receptory P2Y - antagonisté MeSH
- purinergní receptory P2Y12 MeSH
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 St Antonius Hospital Nieuwegein the Netherlands
Department of Cardiology Ziekenhuis Oost Limburg Genk Belgium
Deutsches Herzzentrum München Technische Universität München Munich Germany
Institute of Cardiology Jagiellonian University Medical College Kraków Poland
Interventional Cardiology Division Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy
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