Prevalence and Impact of High Platelet Reactivity in Chronic Kidney Disease
| Autor: | D. Christopher Metzger, Akiko Maehara, Ernest L. Mazzaferri, Michael J. Rinaldi, Helen Parise, Roxana Mehran, Giora Weisz, Ajay J. Kirtane, Ke Xu, Paul A. Gurbel, Bernhard Witzenbichler, Usman Baber, Bruce R. Brodie, David A. Cox, Gregg W. Stone, Georgios Christodoulidis, Timothy D. Henry, Peter L. Duffy, Thomas Stuckey |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Blood Platelets
Male medicine.medical_specialty Platelet Function Tests medicine.medical_treatment Renal function Hemorrhage Coronary Artery Disease urologic and male genital diseases Percutaneous Coronary Intervention Ischemia Internal medicine Post-hoc analysis medicine Humans Prospective Studies Registries Renal Insufficiency Chronic Adverse effect Aged Aged 80 and over Ejection fraction business.industry Confounding Percutaneous coronary intervention Drug-Eluting Stents Middle Aged medicine.disease Surgery Clinical trial Female Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors Kidney disease |
| Zdroj: | Circulation: Cardiovascular Interventions. 8 |
| ISSN: | 1941-7632 1941-7640 |
| DOI: | 10.1161/circinterventions.115.001683 |
| Popis: | Background— Chronic kidney disease (CKD) is associated with increased rates of adverse events after percutaneous coronary intervention. We sought to determine the impact of CKD on platelet reactivity in clopidogrel-treated patients and whether high platelet reactivity (HPR) confers a similar or differential risk for adverse events among patients with CKD and non-CKD. Methods and Results— We performed a post hoc analysis of the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) registry, which included 8582 patients undergoing percutaneous coronary intervention with drug-eluting stents and platelet function testing using the VerifyNow assay. We compared HPR and its impact on ischemic and bleeding events >2 years among patients with CKD and non-CKD. Patients with CKD (n=1367) were older, more often female, diabetic, and had lower ejection fraction compared with their non-CKD counterparts (n=7043). Although HPR prevalence increased with worsening renal function in unadjusted analyses, these associations were no longer present after adjustment. Major adverse cardiac event rates at 2 years among those without CKD or HPR, HPR alone, CKD alone, and both CKD and HPR were 9.0%, 11.2%, 13.3%, and 17.5%, respectively ( P Conclusions— HPR is more common among those with versus without CKD, an association that is attributable to confounding risk factors that are more prevalent in CKD. The impact of HPR on ischemic and bleeding events is similar irrespective of CKD status. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00638794. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|