Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention
Both high and low platelet responses to clopidogrel are highly associated with mortality. A therapeutic window for platelet reactivity was recently determined to be an important factor for improving clinical outcomes after percutaneous coronary intervention (PCI). We evaluated the impact of the anti...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-11-01
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| Series: | Platelets |
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| Online Access: | http://dx.doi.org/10.1080/09537104.2018.1562172 |
| _version_ | 1797684209563729920 |
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| author | Su Nam Lee Donggyu Moon Min Kyung Sung Keon-Woong Moon Ki-Dong Yoo |
| author_facet | Su Nam Lee Donggyu Moon Min Kyung Sung Keon-Woong Moon Ki-Dong Yoo |
| author_sort | Su Nam Lee |
| collection | DOAJ |
| description | Both high and low platelet responses to clopidogrel are highly associated with mortality. A therapeutic window for platelet reactivity was recently determined to be an important factor for improving clinical outcomes after percutaneous coronary intervention (PCI). We evaluated the impact of the antiplatelet activity of clopidogrel on long-term clinical outcomes in Korean patients receiving PCI. We analyzed the clinical outcomes of 814 Korean patients undergoing PCI for a median of 48 months. Platelet reactivity on clopidogrel was measured with the VerifyNow P2Y12 assay. The primary endpoint was all-cause death at 4 years. Patients were classified into three groups according to the P2Y12 reaction unit (PRU): low platelet reactivity (LPR; PRU < 85), normal platelet reactivity (NPR; 85 ≤ PRU < 208), and high platelet reactivity (HPR; PRU ≥ 208). The incidence of all-cause death was 7.0% in the LPR group, 1.5% in the NPR group, and 6.2% in the HPR group (log-rank p = 0.002). Based on multivariate analyses, all-cause death was significantly higher in both the LPR and HPR groups than in the NPR group (LPR, hazard ratio [HR]: 5.095; 95% confidence interval [95% CI]: 1.360–19.080, p = 0.016; HPR, HR: 3.315; 95% CI: 1.145–9.593, p = 0.027). Both LPR and HPR were significantly associated with long-term mortality in Korean patients receiving PCI, which suggests that the therapeutic concept of PRU may be an important prognostic factor. |
| first_indexed | 2024-03-12T00:27:07Z |
| format | Article |
| id | doaj.art-80b8363d4d474457960f60a5757c54fe |
| institution | Directory Open Access Journal |
| issn | 0953-7104 1369-1635 |
| language | English |
| last_indexed | 2024-03-12T00:27:07Z |
| publishDate | 2019-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Platelets |
| spelling | doaj.art-80b8363d4d474457960f60a5757c54fe2023-09-15T10:32:01ZengTaylor & Francis GroupPlatelets0953-71041369-16352019-11-013081030103510.1080/09537104.2018.15621721562172Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary interventionSu Nam Lee0Donggyu Moon1Min Kyung Sung2Keon-Woong Moon3Ki-Dong Yoo4St. Vincent’s Hospital, The Catholic University of KoreaSt. Vincent’s Hospital, The Catholic University of KoreaSt. Vincent’s Hospital, The Catholic University of KoreaSt. Vincent’s Hospital, The Catholic University of KoreaSt. Vincent’s Hospital, The Catholic University of KoreaBoth high and low platelet responses to clopidogrel are highly associated with mortality. A therapeutic window for platelet reactivity was recently determined to be an important factor for improving clinical outcomes after percutaneous coronary intervention (PCI). We evaluated the impact of the antiplatelet activity of clopidogrel on long-term clinical outcomes in Korean patients receiving PCI. We analyzed the clinical outcomes of 814 Korean patients undergoing PCI for a median of 48 months. Platelet reactivity on clopidogrel was measured with the VerifyNow P2Y12 assay. The primary endpoint was all-cause death at 4 years. Patients were classified into three groups according to the P2Y12 reaction unit (PRU): low platelet reactivity (LPR; PRU < 85), normal platelet reactivity (NPR; 85 ≤ PRU < 208), and high platelet reactivity (HPR; PRU ≥ 208). The incidence of all-cause death was 7.0% in the LPR group, 1.5% in the NPR group, and 6.2% in the HPR group (log-rank p = 0.002). Based on multivariate analyses, all-cause death was significantly higher in both the LPR and HPR groups than in the NPR group (LPR, hazard ratio [HR]: 5.095; 95% confidence interval [95% CI]: 1.360–19.080, p = 0.016; HPR, HR: 3.315; 95% CI: 1.145–9.593, p = 0.027). Both LPR and HPR were significantly associated with long-term mortality in Korean patients receiving PCI, which suggests that the therapeutic concept of PRU may be an important prognostic factor.http://dx.doi.org/10.1080/09537104.2018.1562172clinical outcomesclopidogrelp2y12 reaction unittherapeutic window |
| spellingShingle | Su Nam Lee Donggyu Moon Min Kyung Sung Keon-Woong Moon Ki-Dong Yoo Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention Platelets clinical outcomes clopidogrel p2y12 reaction unit therapeutic window |
| title | Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention |
| title_full | Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention |
| title_fullStr | Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention |
| title_full_unstemmed | Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention |
| title_short | Impact of platelet reactivity on long-term prognosis in Korean patients receiving percutaneous coronary intervention |
| title_sort | impact of platelet reactivity on long term prognosis in korean patients receiving percutaneous coronary intervention |
| topic | clinical outcomes clopidogrel p2y12 reaction unit therapeutic window |
| url | http://dx.doi.org/10.1080/09537104.2018.1562172 |
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