Association Between Residual Platelet Reactivity on Clopidogrel Treatment and Severity of Coronary Atherosclerosis: Intrinsic Hypercoagulability as a Mediator

Advances in Therapy
Xin ZhaoJunbo Ge

Abstract

High on-treatment residual platelet reactivity (HRPR) was associated with greater atherosclerosis burden. We examined whether intrinsic hypercoagulability (IHC) could be attributed to that association in patients treated by drug-eluting stents. This retrospective observation enrolled a total of 891 coronary artery disease (CAD) subjects. Platelet and coagulant reactivity was measured by thrombelastography. At least 24 h after a 300-mg dose of clopidogrel, adenosine diphosphate (ADP)-induced maximum amplitude of clot strength (MAadp) > 47 mm represented HRPR. Thrombin-induced platelet-fibrin clot strength (MAthrombin) and blood fibrinogen surrogated intrinsic coagulability. Using mediation analysis to evaluate the effect of IHC on the relationship between the number of narrowed coronaries and HRPR on clopidogrel. More HRPR on clopidogrel and higher intrinsic coagulability were observed in more severe coronary atherosclerosis, especially in the three-vessel disease. After adjustment for confounding factors, the number of narrowed coronaries (ORadj = 1.343, 95% CI 1.063-1.695, p = 0.013), MAthrombin (ORadj = 1.106, 95% CI 1.058-1.157, p < 0.001), and fibrinogen (ORadj = 1.003, 95% CI 1.001-1.005, p = 0.012) were all independent po...Continue Reading

References

Mar 20, 2003·Journal of the American College of Cardiology·Sonia S Anand, Salim Yusuf
Nov 16, 2005·Journal of the American College of Cardiology·Paul A GurbelUdaya S Tantry
Aug 11, 2007·Statistics in Medicine·Jeffrey M Albert
Nov 6, 2007·The New England Journal of Medicine·Stephen D WiviottUNKNOWN TRITON-TIMI 38 Investigators
Feb 21, 2009·The New England Journal of Medicine·Patrick W SerruysUNKNOWN SYNTAX Investigators
Sep 1, 2009·The New England Journal of Medicine·Lars WallentinMona Thorsén
Feb 13, 2010·British Journal of Haematology·Marianne T SeverinsenSøren R Kristensen
Sep 11, 2010·Journal of the American College of Cardiology·Laurent BonelloUNKNOWN Working Group on High On-Treatment Platelet Reactivity
Mar 17, 2011·JAMA : the Journal of the American Medical Association·Matthew J PriceUNKNOWN GRAVITAS Investigators
Jul 6, 2011·Nature Reviews. Cardiology·Giuseppe LippiGiovanni Targher
Nov 15, 2011·The New England Journal of Medicine·Jessica L MegaUNKNOWN ATLAS ACS 2–TIMI 51 Investigators
Oct 5, 2012·The New England Journal of Medicine·UNKNOWN Emerging Risk Factors CollaborationJohn Danesh
Nov 6, 2012·The New England Journal of Medicine·Jean-Philippe ColletUNKNOWN ARCTIC Investigators
Jan 8, 2013·The American Journal of Cardiology·Gjin NdrepepaAdnan Kastrati
Apr 18, 2013·Current Cardiology Reports·Kristopher J SwigerPaul A Gurbel
Apr 25, 2013·European Journal of Clinical Investigation·Thomas GremmelSimon Panzer
Oct 1, 2013·Journal of the American College of Cardiology·Udaya S TantryUNKNOWN Working Group on On-Treatment Platelet Reactivity
Dec 18, 2013·Thrombosis and Haemostasis·Charles T Esmon
Sep 5, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Stephan WindeckerAdam Witkowski
Aug 29, 2017·The New England Journal of Medicine·John W EikelboomUNKNOWN COMPASS Investigators
Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Anders JeppssonMarco Valgimigli

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.