| Relation of low response to clopidogrel assessed with point-of-care assay to periprocedural myonecrosis in patients undergoing elective coronary stenting for stable angina pectoris. | |
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MedLine Citation:
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PMID: 18549843 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Impaired responses to antiplatelet therapy assessed by laboratory tests are associated with an increased risk of recurrent ischemic events after percutaneous coronary intervention (PCI). This study was designed to determine the relation between responses to aspirin and clopidogrel as assessed by a point-of-care assay (Verify Now, Accumetrics, San Diego, California) and periprocedural myocardial infarction (PMI) in patients undergoing elective PCI for stable angina. One hundred twenty-two consecutive patients undergoing elective coronary stenting prospectively received aspirin 500 mg and clopidogrel 600 mg >or=12 hours before PCI. Clopidogrel response was measured with P2Y12 reaction units (PRUs) and percent inhibition P2Y12 from baseline (percent inhibition P2Y12) and aspirin response with aspirin reaction units (ARUs). Troponin T level was considered positive if it was >0.03 ng/ml. Responses to aspirin and clopidogrel were correlated (r=0.42, p <0.0001). PMI occurred in 27 patients (22%) who showed significantly lower percent inhibition P2Y12 (25.3+/-26 vs 38.3+/-25, p=0.01) and a trend toward higher PRU values (221+/-87 vs 193+/-94, p=0.21). We did not find any difference for aspirin response as assessed by ARUs in patients with or without PMI (460+/-82 vs 454+/-73, p = 0.82). Stratification of percent inhibition P2Y12 isolated a quartile of clopidogrel nonresponders (inhibition P2Y12 <15%) with significantly higher incidence of PMI (44% vs 15%, odds ratio 4.6, 95% confidence interval 1.9 to 11.5, p=0.001). In conclusion, point-of-care assessment of clopidogrel response reliably predicted PMI after low- to medium-risk elective PCI for stable angina. |
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Authors:
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Thomas Cuisset; Michalis Hamilos; Jaydeep Sarma; Giovanna Sarno; Eric Wyffels; Marc Vanderheyden; Emanuele Barbato; Jozef Bartunek; Bernard De Bruyne; William Wijns |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-04-18 |
Journal Detail:
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Title: The American journal of cardiology Volume: 101 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-13 Completed Date: 2008-07-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1700-3 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Center, OLV Hospital, Aalst, Belgium. thomascuisset@voila.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / blood, surgery* Aspirin / therapeutic use Confidence Intervals Female Follow-Up Studies Humans Incidence Male Myocardial Infarction / blood, epidemiology, prevention & control* Myocardial Revascularization / methods* Odds Ratio Platelet Aggregation Inhibitors / therapeutic use Point-of-Care Systems / standards* Preoperative Care Prospective Studies Risk Factors Stents* Surgical Procedures, Elective / methods* Ticlopidine / analogs & derivatives*, therapeutic use Treatment Outcome Troponin T / blood |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 0/Troponin T; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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