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ID 34785
file
creator
Motoda, Chikaaki
Ueda, Hironori
Hayashi, Yasuhiko
Toyofuku, Mamoru
Okimoto, Tomokazu
Otsuka, Masaya
Tamekiyo, Hiromichi
Kawase, Tomoharu
subject
Anti-platelet therapy
Drug-eluting stent
Percutaneous coronary intervention
Platelet reactivity to ADP
Revascularization
NDC
Medical sciences
abstract
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)
journal title
Circulation Journal
volume
Volume 76
issue
Issue 3
start page
641
end page
649
date of issued
2012
publisher
Japanese Circulation Society
issn
1346-9843
ncid
publisher doi
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
publisher
rights
(c) All rights are reserved to the Japanese Circulation Society.
relation url
department
Graduate School of Biomedical Science



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