Impact of platelet turnover on long‐term adverse cardiovascular outcomes in patients undergoing percutaneous coronary intervention
| Autor: | Florian Egger, Alexander Geppert, Veronika Bruno, Wolfgang Hübl, Martin Willheim, Serdar Farhan, Matthias K. Freynhofer, Miklos Rohla, Thomas W. Weiss, Maximilian Tscharre, Johann Wojta, Kurt Huber |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Platelet Function Tests medicine.medical_treatment Clinical Biochemistry Myocardial Infarction Coronary Artery Disease 030204 cardiovascular system & hematology Biochemistry Coronary artery disease 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Internal medicine Humans Medicine cardiovascular diseases 030212 general & internal medicine Myocardial infarction Acute Coronary Syndrome Mean platelet volume Non-ST Elevated Myocardial Infarction Aged Proportional Hazards Models Aspirin Platelet Count business.industry Percutaneous coronary intervention General Medicine Middle Aged Prognosis medicine.disease Clopidogrel Stroke Cardiovascular Diseases Multivariate Analysis Conventional PCI Cardiology ST Elevation Myocardial Infarction Female business Mean Platelet Volume Platelet Aggregation Inhibitors Mace medicine.drug |
| Zdroj: | Europe PubMed Central Publons |
| ISSN: | 1365-2362 0014-2972 |
| DOI: | 10.1111/eci.13157 |
| Popis: | Background Increased platelet turnover and high platelet reactivity are associated with short-term major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) or stable coronary artery disease (SCAD). We investigated the impact of platelet turnover on long-term MACE. Methods Consecutive patients presenting with ACS or SCAD undergoing PCI between 2009 and 2010 were included. All patients received clopidogrel and aspirin as dual antithrombotic therapy regimen. Multivariable Cox proportional hazard models were applied to assess the prognostic impact of platelet turnover (reticulated platelet count [RPC], mean platelet volume [MPV]) and function on long-term MACE, a composite of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke. Results In total, 477 patients were eligible. Mean age was 64.3 ± 12.7 years, 68.8% were male. Median follow-up was 5.8 (IQR 4.2-6.5) years. Median RPC was 7.6 (IQR 5.6-10.4) g/L and median MPV was 10.7 (IQR 10.1-11.3) fL. In univariable analysis, RPC was associated with MACE, both as continuous (HR 1.064 [95%CI 1.021-1.111]; P = .006) and dichotomized (HR 1.693 [95%CI 1.156-2.481]; P = .006) variable. After adjustment, continuous RPC (HR 1.055 [95%CI 1.012-1.099]; P = .010) and dichotomized RPC (HR 1.716 [95%CI 1.152-2.559]; P = .007) remained significantly associated with MACE. Neither MPV nor platelet function testing was associated with long-term adverse outcome. Conclusion Increased platelet turnover is associated with long-term adverse outcome in patients with coronary artery disease undergoing PCI. Platelet turnover represents a new marker of atherothrombotic risk and might help to guide composition or duration of antiplatelet therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|