The impact of oral antiplatelet responsiveness on the long-term prognosis after coronary stenting.

Abstract:

BACKGROUND:Decreased responsiveness to oral antiplatelet drug therapy has been associated with an adverse outcome after coronary stenting (CS), but more studies are needed. The purpose of the present study was to prospectively evaluate this issue. METHODS:A total of 612 consecutive patients with stable or unstable coronary artery disease who underwent CS after at least 12 hours of aspirin and clopidogrel loading were studied. The study population was divided into responders and nonresponders to oral antiplatelet therapy, according to the values of preprocedural Platelet Function Analyzer-100 (Dade Behring, Marburg, Germany) collagen epinephrine closure time (CEPI-CT). In particular, responders were considered as patients with a CEPI-CT > 193 seconds and nonresponders as those with a CEPI-CT < or = 193 seconds. The 1-year incidence of the composite of cardiac death and rehospitalization for nonfatal myocardial infarction was the prespecified primary study end point. RESULTS:At 1 year, 9.1% of patients reached the primary end point. Nonresponders to oral antiplatelet therapy were at significantly higher risk for the primary end point (18.7% vs 7.6%) than responders. Nonresponsiveness to oral antiplatelet therapy was a predictor of the primary end point by both univariate (hazard ratio 2.7, 95% CI 1.6-4.5, P < .001) and multivariate (hazard ratio 2.5, 95% CI 1.6-3.8, P < .001) Cox regression analysis. CONCLUSION:Based on the present data, preprocedural responsiveness to oral antiplatelet therapy, assessed by Platelet Function Analyzer-100 CEPI-CT, is an independent predictor of long-term outcome after CS.

journal_name

Am Heart J

journal_title

American heart journal

authors

Foussas SG,Zairis MN,Patsourakos NG,Makrygiannis SS,Adamopoulou EN,Handanis SM,Prekates AA,Fakiolas CN,Pissimissis EG,Olympios CD,Argyrakis SK

doi

10.1016/j.ahj.2007.06.013

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

676-81

issue

4

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(07)00513-3

journal_volume

154

pub_type

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