The challenge for predicting bleeding events by assessing platelet reactivity following coronary stenting

International Journal of Cardiology
Sun Young ChoiVictor Serebruany

Abstract

Predicting future bleeding events represents an unmet medical need that will ultimately improve outcomes during dual antiplatelet therapy (DAPT). Although low platelet reactivity (LPR) may be linked to bleeding, standardized and clinically validated threshold for reliable DAPT bleeding risk stratification is lacking. We sought to define the predictive value of LPR for future bleeding events in a large cohort of post-stenting single-center Korean patients. Consecutive patients (n=800) who underwent coronary interventions with drug-eluting stents were enrolled from March 2010 to October 2014. Among them, 699 (80%) were treated with 75mg/daily clopidogrel, 93 (19%) with 10mg/daily prasugrel, and 8 (1%) with 180mg/daily ticagrelor, all on top of 100mg/daily aspirin. Bleeding was assessed by BARC 2-5 scale, and events were collected for 1-year post stenting. Platelet reactivity on DAPT was measured by the VerifyNow P2Y12 assay at 1month following coronary intervention. There were a total of 18 (2.1%) bleeding events. The LPR value defined as ≤139 PRU (AUC: 0.867, p<0.0001) was an independent predictor for bleeding (HR=21.26, 95% CI: 6.19-73.0, p<0.0001) by univariate analysis, and remains significant (HR=11.49; 95% CI: 2.89-45.67, p...Continue Reading

References

Aug 25, 2001·Lancet·S R MehtaUNKNOWN Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators
Apr 17, 2003·British Journal of Anaesthesia·M FattoruttoL Barvais
Jun 25, 2003·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Paul BarraganMartin Eigenthaler
Oct 27, 2004·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Stan HeptinstallRobert G Wilcox
Nov 6, 2007·The New England Journal of Medicine·Stephen D WiviottUNKNOWN TRITON-TIMI 38 Investigators
Sep 1, 2009·The New England Journal of Medicine·Lars WallentinMona Thorsén
Mar 17, 2011·JAMA : the Journal of the American Medical Association·Matthew J PriceUNKNOWN GRAVITAS Investigators
Aug 1, 2015·European Journal of Gastroenterology & Hepatology·Wilma Debernardi VenonAlfredo Marzano
Sep 1, 2015·Journal of the American College of Cardiology·Philippe GénéreuxGregg W Stone
Oct 9, 2015·Clinical Cardiology·Wiktor KuliczkowskiVictor Serebruany

❮ 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.