Low Levels of High-Density Lipoprotein Cholesterol Are Linked to Impaired Clopidogrel-Mediated Platelet Inhibition
| Autor: | Thomas Gremmel, Renate Koppensteiner, Patricia P. Wadowski, Christoph W. Kopp, Simon Panzer, Silvia Lee |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Platelet Aggregation medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine P2Y12 High-density lipoprotein Angioplasty Internal medicine medicine Humans Platelet 030212 general & internal medicine Aged Aspirin business.industry Cholesterol Cholesterol HDL Middle Aged Atherosclerosis Clopidogrel Adenosine Diphosphate Adenosine diphosphate Endocrinology chemistry Drug Therapy Combination Female Stents lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | Angiology. 69:786-794 |
| ISSN: | 1940-1574 0003-3197 |
| Popis: | Low high-density lipoprotein cholesterol (HDL-C) levels are an independent predictor of ischemic events in patients with atherosclerotic cardiovascular disease. This may in part be due to decreased clopidogrel-mediated platelet inhibition in patients with low HDL-C. We investigated the association of HDL-C with on-treatment platelet reactivity to adenosine diphosphate (ADP) in 314 patients on dual antiplatelet therapy with clopidogrel and aspirin undergoing angioplasty and stenting. Platelet P-selectin expression was assessed by flow cytometry, and platelet aggregation was determined by the VerifyNow P2Y12 assay and the Impact-R. High-density lipoprotein cholesterol levels were inversely associated with P-selectin expression and the VerifyNow P2Y12 assay (both P ≤ .01). Moreover, we found a positive correlation of HDL-C with surface coverage by the Impact-R ( P = .003). Patients with low HDL-C (≤35 mg/dL) exhibited a significantly higher P-selectin expression in response to ADP and higher platelet aggregation by the VerifyNow P2Y12 assay and the Impact-R than patients with normal HDL-C (>35 mg/dL; all P < .05). High on-treatment residual platelet reactivity by the VerifyNow P2Y12 assay occurred significantly more frequently in patients with low HDL-C levels than in those with normal HDL-C (47.4% vs 30.1%, P = .01). In conclusion, low HDL-C is linked to impaired clopidogrel-mediated platelet inhibition after angioplasty and stenting. |
| Databáze: | OpenAIRE |
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