Impact of Platelet Reactivity to Adenosine Diphosphate Before Implantation of Drug-Eluting Stents on Subsequent Adverse Cardiac Events in Patients With Stable Angina

Circulation Journal 76 巻 3 号 641-649 頁 2012 発行
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タイトル ( eng )
Impact of Platelet Reactivity to Adenosine Diphosphate Before Implantation of Drug-Eluting Stents on Subsequent Adverse Cardiac Events in Patients With Stable Angina
作成者
Motoda Chikaaki
Ueda Hironori
Hayashi Yasuhiko
Toyofuku Mamoru
Okimoto Tomokazu
Otsuka Masaya
Tamekiyo Hiromichi
Kawase Tomoharu
収録物名
Circulation Journal
76
3
開始ページ 641
終了ページ 649
抄録
Background: Diverse pharmacological effects of anti-platelet thienopyridines due to individual differences in metabolism have been reported. However, an association between on-treatment platelet reactivity and adverse ischemic events after drug-eluting stent (DES) implantation in Japanese patients has not been fully elucidated.

Methods and Results: A total of 450 consecutive patients on dual anti-platelet therapy (aspirin and ticlopidine) with stable angina who underwent DES implantation were enrolled. Adenosine diphosphate (ADP)-induced platelet aggregation was measured before DES implantation using the screen filtration pressure method. The ADP concentration necessary for 50% aggregation was designated as the platelet aggregation threshold index (PATI). A composite primary endpoint of cardiac death, myocardial infarction, target lesion revascularization (TLR), and stent thrombosis occurring within 1 year after stenting, was evaluated. A PATI value <4.8 mu mol/L was defined as high on-treatment reactivity to ADP. The composite primary endpoint occurred in 55 patients (12.2%) in the 1-year-period after DES implantation, and the prevalence was 19.0% and 5.1% in groups with high and low on-treatment reactivity to ADP, respectively, showing a significantly higher prevalence in the high reactivity group (P<0.001). The main event was TLR (18.1% vs. 5.1%, P<0.001).

Conclusions: These data suggested that high on-treatment platelet reactivity to ADP and subsequent occurrence of adverse ischemic events (particularly TLR) were correlated in patients with stable angina who underwent DES implantation. (Circ J 2012; 76: 641-649)
著者キーワード
Anti-platelet therapy
Drug-eluting stent
Percutaneous coronary intervention
Platelet reactivity to ADP
Revascularization
NDC分類
医学 [ 490 ]
言語
英語
資源タイプ 学術雑誌論文
出版者
Japanese Circulation Society
発行日 2012
権利情報
(c) All rights are reserved to the Japanese Circulation Society.
出版タイプ Version of Record(出版社版。早期公開を含む)
アクセス権 オープンアクセス
収録物識別子
[ISSN] 1346-9843
[DOI] 10.1253/circj.CJ-11-0435
[NCID] AA11591968
[DOI] http://dx.doi.org/10.1253/circj.CJ-11-0435