High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions
Patient response to P2Y12 inhibitor therapy is heterogeneous, and those with high on-treatment platelet reactivity (HTPR) are at an increased risk of thrombotic complications. The aim of our study was to determine whether selecting a high-risk patient group of individuals after complex percutaneous...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-09-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296231199089 |
| _version_ | 1827820433719689216 |
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| author | Lukáš Urban MD, PhD Škorňová Ingrid Ing, PhD Jana Žolková Ing, PhD Staško Ján MD, PhD Tomáš Bolek MD, PhD Matej Samoš MD, PhD |
| author_facet | Lukáš Urban MD, PhD Škorňová Ingrid Ing, PhD Jana Žolková Ing, PhD Staško Ján MD, PhD Tomáš Bolek MD, PhD Matej Samoš MD, PhD |
| author_sort | Lukáš Urban MD, PhD |
| collection | DOAJ |
| description | Patient response to P2Y12 inhibitor therapy is heterogeneous, and those with high on-treatment platelet reactivity (HTPR) are at an increased risk of thrombotic complications. The aim of our study was to determine whether selecting a high-risk patient group of individuals after complex percutaneous coronary intervention (PCI) would show the clinical benefit of HTPR testing for preventing thrombotic complications. Blood samples of patients after complex PCI were acquired 1 day and 1 month after the intervention. The samples were tested using vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) and platelet function assay (PFA). The occurrence of clinically significant stent thrombosis with repeated revascularization of the target vessel was observed over a 1-year period. One day after PCI, 37% of patients had HTPR as established by VASP-P. One month after PCI, the percentage of patients with HTPR decreased to 30.9%. According to PFA, 1 day after PCI, 33.3% of patients had HTPR. This percentage declined to 19.8% after 1 month. All measurements identified a significantly higher proportion of HTPR in patients on clopidogrel compared to ticagrelor and prasugrel. Two cases of early stent thrombosis and 1 case of late stent thrombosis were identified. Further study of adenosine diphosphate receptor blocker on-treatment response in patients undergoing complex PCI is necessary. |
| first_indexed | 2024-03-12T01:27:50Z |
| format | Article |
| id | doaj.art-e9cfec33bc6144ceb0c0c070d29fab1d |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-03-12T01:27:50Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-e9cfec33bc6144ceb0c0c070d29fab1d2023-09-12T13:03:34ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232023-09-012910.1177/10760296231199089High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary InterventionsLukáš Urban MD, PhD0Škorňová Ingrid Ing, PhD1 Jana Žolková Ing, PhD2Staško Ján MD, PhD3 Tomáš Bolek MD, PhD4Matej Samoš MD, PhD5 Department of Cardiology, University Hospital Martin, Martin, Slovakia Department of Hematology and Transfusiology, Jessenius Faculty of Medicine, Comenius University, University Hospital Martin, Martin, Slovakia Department of Hematology and Transfusiology, Jessenius Faculty of Medicine, Comenius University, University Hospital Martin, Martin, Slovakia Department of Hematology and Transfusiology, Jessenius Faculty of Medicine, Comenius University, University Hospital Martin, Martin, Slovakia Department of Internal Medicine I., Jessenius Faculty of Medicine, Comenius University, University Hospital Martin, Martin, Slovakia Department of Internal Medicine I., Jessenius Faculty of Medicine, Comenius University, University Hospital Martin, Martin, SlovakiaPatient response to P2Y12 inhibitor therapy is heterogeneous, and those with high on-treatment platelet reactivity (HTPR) are at an increased risk of thrombotic complications. The aim of our study was to determine whether selecting a high-risk patient group of individuals after complex percutaneous coronary intervention (PCI) would show the clinical benefit of HTPR testing for preventing thrombotic complications. Blood samples of patients after complex PCI were acquired 1 day and 1 month after the intervention. The samples were tested using vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) and platelet function assay (PFA). The occurrence of clinically significant stent thrombosis with repeated revascularization of the target vessel was observed over a 1-year period. One day after PCI, 37% of patients had HTPR as established by VASP-P. One month after PCI, the percentage of patients with HTPR decreased to 30.9%. According to PFA, 1 day after PCI, 33.3% of patients had HTPR. This percentage declined to 19.8% after 1 month. All measurements identified a significantly higher proportion of HTPR in patients on clopidogrel compared to ticagrelor and prasugrel. Two cases of early stent thrombosis and 1 case of late stent thrombosis were identified. Further study of adenosine diphosphate receptor blocker on-treatment response in patients undergoing complex PCI is necessary.https://doi.org/10.1177/10760296231199089 |
| spellingShingle | Lukáš Urban MD, PhD Škorňová Ingrid Ing, PhD Jana Žolková Ing, PhD Staško Ján MD, PhD Tomáš Bolek MD, PhD Matej Samoš MD, PhD High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions Clinical and Applied Thrombosis/Hemostasis |
| title | High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions |
| title_full | High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions |
| title_fullStr | High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions |
| title_full_unstemmed | High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions |
| title_short | High On-Treatment Platelet Reactivity in Patients Undergoing Complex Percutaneous Coronary Interventions |
| title_sort | high on treatment platelet reactivity in patients undergoing complex percutaneous coronary interventions |
| url | https://doi.org/10.1177/10760296231199089 |
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