High residual platelet reactivity after clopidogrel: extent of coronary atherosclerosis and periprocedural myocardial infarction in patients with stable angina undergoing percutaneous coronary intervention

JACC. Cardiovascular Interventions
Fabio MangiacapraEmanuele Barbato

Abstract

We tested the hypothesis that residual platelet reactivity after clopidogrel correlates with the extent and severity of coronary atherosclerosis in patients undergoing elective percutaneous coronary intervention (PCI). Platelets are actively involved in vascular atherosclerosis. We prospectively enrolled 338 patients undergoing PCI for stable angina, loaded with 600-mg clopidogrel. Platelet reactivity was assessed 12 h later by measuring P2Y12 reactivity unit (PRU) with VerifyNow P2Y12 assay (Accumetrics, San Diego, California). High platelet reactivity (HPR) was defined as PRU value >or=240. Presence of multivessel disease (MVD) and total stent length (TSL) were used as surrogate markers of atherosclerosis severity and extension. Patients with MVD showed higher PRU compared with single-vessel disease (SVD) patients (222 +/- 85 vs. 191 +/- 73; p < 0.001). The PRU increased with the number of stenotic coronaries (1-vessel disease: 191 +/- 73; 2-vessel disease: 220 +/- 88; 3-vessel disease: 226 +/- 80; p = 0.002). The PRU was higher in the third TSL tertile compared with first tertile (217 +/- 83 vs. 191 +/- 73; p = 0.048). The HPR was most frequently observed among MVD patients (40.5% vs. 21.6% in patients with SVD, respectively...Continue Reading

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Citations

Dec 13, 2012·Journal of Cardiovascular Translational Research·Olivier MullerEmanuele Barbato
Jan 12, 2013·Journal of Cardiovascular Translational Research·Jozef BartunekJosefin-Beate Holz
Jan 4, 2013·Journal of Cardiovascular Translational Research·Annunziata NuscaGermano Di Sciascio
Dec 29, 2012·Journal of Cardiovascular Translational Research·Fabio Mangiacapra, Emanuele Barbato
Mar 3, 2012·Annals of Medicine·Nadzeya KuzniatsovaGregory Y H Lip
Dec 25, 2015·Clinical and Experimental Pharmacology & Physiology·Snežana MugošaZoran Todorović
Jan 26, 2012·Thrombosis and Haemostasis·Nora MalloukSilvy Laporte
Oct 9, 2012·Journal of Thrombosis and Haemostasis : JTH·F MangiacapraE Barbato
Jan 12, 2017·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·J F M MarchiniJ A Marin-Neto
May 16, 2017·Platelets·Eduardo FuentesChrista E Müller
Feb 17, 2018·Journal of Thrombosis and Thrombolysis·Fabio MangiacapraGermano Di Sciascio
Jan 15, 2014·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Vacis TatarunasVaiva Lesauskaite
Jul 10, 2019·Journal of Cardiovascular Pharmacology and Therapeutics·Eduardo FuentesAndres Trostchansky
May 16, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Mariano PellicanoEmanuele Barbato
Sep 2, 2011·Clinical Pharmacology and Therapeutics·F MangiacapraJ Bartunek
Aug 11, 2020·Thrombosis and Haemostasis·Thorsten KesslerPhilipp von Hundelshausen
Jun 27, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Mohamad SoudHector M Garcia-Garcia
Apr 15, 2021·Journal of Cardiovascular Translational Research·Fabio MangiacapraFrancesco Grigioni

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