High platelet reactivity on aspirin in patients with acute ST elevation myocardial infarction
| Autor: | Sebastian Voicu, Patrick Henry, Stephane Manzo Silberman, Jean-Guillaume Dillinger, Claire Bal dit Sollier, Ludovic Drouet, Georgios Sideris, Alaa Saeed, Vincent Spagnoli |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Blood Platelets
Male Ticagrelor medicine.medical_specialty Adenosine Ticlopidine Prasugrel Platelet Aggregation Platelet Function Tests macromolecular substances 030204 cardiovascular system & hematology Loading dose Brain Ischemia 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Prospective Studies cardiovascular diseases 030212 general & internal medicine Myocardial infarction Aspirin Ejection fraction business.industry Maintenance dose Hematology Middle Aged medicine.disease Clopidogrel Survival Analysis carbohydrates (lipids) Cardiovascular Diseases Acute Disease Purinergic P2Y Receptor Antagonists Cardiology ST Elevation Myocardial Infarction bacteria Female business Prasugrel Hydrochloride Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | Thrombosis Research. 144:56-61 |
| ISSN: | 0049-3848 |
| DOI: | 10.1016/j.thromres.2016.05.002 |
| Popis: | Background Despite dual antiplatelet treatment, major ischemic events are common following ST elevation myocardial infarction (STEMI). We aimed to assess high platelet reactivity on aspirin (HPR-aspirin) and its association with P2Y12i (HPR-P2Y12i) during the acute phase of STEMI. Methods We included all consecutive patients admitted for STEMI treated by primary angioplasty in our center for 1 year. All patients received a loading dose followed by a maintenance dose of aspirin (75 mg/day) and prasugrel (ticagrelor or clopidogrel if contraindicated). Platelet reactivity was assessed 4 ± 1 days and 75 ± 15 days after admission using light transmission aggregometry with arachidonic acid (LTA-AA–HPR-aspirin) and VASP (HPR-P2Y12i) to define HPR as well as serum Thromboxane-B2 and LTA-ADP. Major cardiac and cerebrovascular events were recorded for 1 year. Results We included 106 patients – mean age was 61 y.o., 76% were male and 20% had diabetes. STEMI was anterior in 52% and LV ejection fraction at discharge was 51 ± 9%. 50% of patients were treated with prasugrel and 34% with ticagrelor. At day 4 after STEMI, HPR-aspirin was found in 26% patients and HPR-P2Y12i in 7%. HPR- both aspirin and P2Y12i was found in 4%. Diabetes and age were predictors of HPR-aspirin. HPR-aspirin was persistent 75 days later in 36% patients. At 1 year, 7.9% patients had experienced major adverse cardiovascular and cerebrovascular events (MACCE). HPR-aspirin and HPR on both aspirin and P2Y12i were significantly associated with MACCE. Conclusion HPR-aspirin is frequent just after STEMI and associated with MACCE especially when associated with HPR-P2Y12i. |
| Databáze: | OpenAIRE |
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