Prognostic impact of high residual platelet reactivity after chronic total occlusion percutaneous coronary intervention in patients with diabetes mellitus

International Journal of Cardiology
Renato ValentiDavid Antoniucci

Abstract

The study sought to determine the impact of high residual platelet reactivity (HRPR) on long-term cardiac mortality in diabetic patients treated with PCI for CTO. No data exist about the impact of HRPR after 600 mg clopidogrel loading on long-term clinical outcome in patients with diabetes mellitus and treated with percutaneous coronary angioplasty (PCI) for chronic total occlusion (CTO). From the Florence CTO-PCI registry, we identified consecutive diabetic patients with available in vitro platelet reactivity assessment by light transmittance aggregometry after a loading dose of 600 mg of clopidogrel. HRPR was defined as residual platelet aggregation by 10 μmol/L ADP test ≥70%. The primary end point of the study was long-term cardiac mortality. Two-hundred and three diabetic patients underwent CTO-PCI. The incidence of HRPR was 23%. The 3-year cardiac survival was lower in the HRPR group than the low residual platelet reactivity (LRPR) group (70 ± 7% and 92 ± 3%, respectively; p=0.001). Within the oral antidiabetic patients there were no significant differences in long-term survival between HRPR and LRPR groups. Conversely, the association of insulin therapy and HRPR was related to a dramatic decrease in survival compared to t...Continue Reading

References

Jun 25, 2003·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Paul BarraganMartin Eigenthaler
Jul 18, 2006·Journal of the American College of Cardiology·Dominick J AngiolilloAntonio Fernandez-Ortiz
May 2, 2007·Circulation·Donald E CutlipUNKNOWN Academic Research Consortium
Jun 19, 2007·Journal of the American College of Cardiology·Piergiovanni BuonamiciDavid Antoniucci
Oct 16, 2007·Journal of the American College of Cardiology·Dominick J AngiolilloAntonio Fernandez-Ortiz
Nov 6, 2007·Journal of the American College of Cardiology·Paul A GurbelAlan D Michelson
Feb 25, 2010·JAMA : the Journal of the American Medical Association·Nicoline J BreetJurriën M ten Berg
Aug 9, 2011·The American Journal of Cardiology·Bimmer E ClaessenUNKNOWN Multinational Cto Registry
Jan 1, 2013·Journal of the American College of Cardiology·Renato ValentiDavid Antoniucci
Jan 16, 2013·International Journal of Cardiology·Cosmo GodinoAntonio Colombo
Feb 16, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Arie Pieter KappeteinUNKNOWN SYNTAX Investigators
Sep 26, 2013·The American Journal of Cardiology·Gian Battista DanziDavid Antoniucci

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Citations

Nov 29, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Francesca SanguinetiYves Louvard
Sep 27, 2018·Nature Reviews. Cardiology·Giuseppe PattiUNKNOWN Working Group on Thrombosis of the Italian Society of Cardiology
Nov 8, 2020·Journal of Thrombosis and Thrombolysis·Margaret InfeldDeepak Voora

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