An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention
Abstract Objective This study was aimed to determine how platelet reactivity (PR) on dual antiplatelet therapy predicts ischemic and bleeding events in patients underwent percutaneous coronary intervention (PCI). Design A total of 2768 patients who had received coronary stent implantation and had ta...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-021-00323-5 |
| _version_ | 1818723288619155456 |
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| author | Jing Wang Jing Wang Zhou Dong Jiazheng Ma Jianzhen Teng Tong Wang Xiaofeng Zhang Qian Gu Zekang Ye Inam Ullah Chuchu Tan Samee Abdus Lu Shi Xiaoxuan Gong Chunjian Li |
| author_facet | Jing Wang Jing Wang Zhou Dong Jiazheng Ma Jianzhen Teng Tong Wang Xiaofeng Zhang Qian Gu Zekang Ye Inam Ullah Chuchu Tan Samee Abdus Lu Shi Xiaoxuan Gong Chunjian Li |
| author_sort | Jing Wang |
| collection | DOAJ |
| description | Abstract Objective This study was aimed to determine how platelet reactivity (PR) on dual antiplatelet therapy predicts ischemic and bleeding events in patients underwent percutaneous coronary intervention (PCI). Design A total of 2768 patients who had received coronary stent implantation and had taken aspirin 100 mg in combination with clopidogrel 75 mg daily for > 5 days were consecutively screened and 1885 were enrolled. The recruited patients were followed-up for 12 months. The primary end-point was the net adverse clinical events (NACE) of cardiovascular death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and any bleeding. Result 1709 patients completed the clinical follow-up. By using the receiver operating characteristic (ROC) curve analysis, the optimal cut-off values were found to be 37.5 and 25.5% respectively in predicting ischemic and bleeding events. Patients were classified into 2 groups according to PR: inside the window group (IW) [adenosine diphosphate (ADP) induced platelet aggregation (PLADP) 25.5–37.4%)] and outside the window group (OW) (PLADP < 25.5% or ≥ 37.5%). The incidence of NACE was 16.8 and 23.1% respectively in the IW and OW group. The hazard ratio of NACE in IW group was significantly lower [0.69 (95% CI, 0.54–0.89, P = 0.004)] than that in the OW group during 12-month follow-up. Conclusion An optimal therapeutic window of 25.5–37.4% for PLADP predicts the lowest risk of NACE, which could be referred for tailored antiplatelet treatment while using LTA assay. Trial registration Trial registration number: ClinicalTrials.gov NCT01968499 . Registered 18 October 2013 - Retrospectively registered. |
| first_indexed | 2024-12-17T21:08:08Z |
| format | Article |
| id | doaj.art-1283eaf94b9942cab854b63331b6c057 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-17T21:08:08Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-1283eaf94b9942cab854b63331b6c0572022-12-21T21:32:31ZengBMCThrombosis Journal1477-95602021-10-011911910.1186/s12959-021-00323-5An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary interventionJing Wang0Jing Wang1Zhou Dong2Jiazheng Ma3Jianzhen Teng4Tong Wang5Xiaofeng Zhang6Qian Gu7Zekang Ye8Inam Ullah9Chuchu Tan10Samee Abdus11Lu Shi12Xiaoxuan Gong13Chunjian Li14Departments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityDepartments of Cardiology, the First Affiliated Hospital of Nanjing Medical UniversityAbstract Objective This study was aimed to determine how platelet reactivity (PR) on dual antiplatelet therapy predicts ischemic and bleeding events in patients underwent percutaneous coronary intervention (PCI). Design A total of 2768 patients who had received coronary stent implantation and had taken aspirin 100 mg in combination with clopidogrel 75 mg daily for > 5 days were consecutively screened and 1885 were enrolled. The recruited patients were followed-up for 12 months. The primary end-point was the net adverse clinical events (NACE) of cardiovascular death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and any bleeding. Result 1709 patients completed the clinical follow-up. By using the receiver operating characteristic (ROC) curve analysis, the optimal cut-off values were found to be 37.5 and 25.5% respectively in predicting ischemic and bleeding events. Patients were classified into 2 groups according to PR: inside the window group (IW) [adenosine diphosphate (ADP) induced platelet aggregation (PLADP) 25.5–37.4%)] and outside the window group (OW) (PLADP < 25.5% or ≥ 37.5%). The incidence of NACE was 16.8 and 23.1% respectively in the IW and OW group. The hazard ratio of NACE in IW group was significantly lower [0.69 (95% CI, 0.54–0.89, P = 0.004)] than that in the OW group during 12-month follow-up. Conclusion An optimal therapeutic window of 25.5–37.4% for PLADP predicts the lowest risk of NACE, which could be referred for tailored antiplatelet treatment while using LTA assay. Trial registration Trial registration number: ClinicalTrials.gov NCT01968499 . Registered 18 October 2013 - Retrospectively registered.https://doi.org/10.1186/s12959-021-00323-5Light transmittance aggregometryPlatelet reactivityPercutaneous coronary interventionTherapeutic window |
| spellingShingle | Jing Wang Jing Wang Zhou Dong Jiazheng Ma Jianzhen Teng Tong Wang Xiaofeng Zhang Qian Gu Zekang Ye Inam Ullah Chuchu Tan Samee Abdus Lu Shi Xiaoxuan Gong Chunjian Li An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention Thrombosis Journal Light transmittance aggregometry Platelet reactivity Percutaneous coronary intervention Therapeutic window |
| title | An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention |
| title_full | An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention |
| title_fullStr | An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention |
| title_full_unstemmed | An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention |
| title_short | An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention |
| title_sort | optimal window of platelet reactivity by lta assay for patients undergoing percutaneous coronary intervention |
| topic | Light transmittance aggregometry Platelet reactivity Percutaneous coronary intervention Therapeutic window |
| url | https://doi.org/10.1186/s12959-021-00323-5 |
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