A Point-of-Care Platelet Function Assay and C-Reactive Protein for Prediction of Major Cardiovascular Events After Drug-Eluting Stent Implantation

Park, Duk‐Woo; Lee, Seung-Whan; Yun, Sung‐Cheol; Song, Hae-Geun; Ahn, Jung‐Min; Lee, Jong‐Young; Kim, Won-Jang; Kang, Soo-Jin; Kim, Young‐Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Seung‐Jung

doi:10.1016/j.jacc.2011.08.057

Cited by 64 publications

(33 citation statements)

References 28 publications

(46 reference statements)

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“…As regards laboratory parameters, white blood cell count (N 10,000 cells/μl) was significantly higher in patients with unfavorable prognosis and independent predictor of death at multivariate analysis. This confirms that the exaggerate inflammatory response occurring in these patients contributes to the worse prognosis [23,24].…”

Section: Discussionsupporting

confidence: 77%

Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention

Attanasio

Marcucci

Gori

et al. 2016

Thrombosis Research

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Introduction: Thrombin generation (TG) is a central step of the coagulation system involved in hemostatic and thrombotic roles. Scarce data evaluating in the acute phase the association between TG and the risk of cardiovascular death of acute coronary syndrome (ACS) patients are available, in the era of percutaneous coronary intervention (PCI) and stenting with the use of dual antiplatelet treatment. Conclusions: ACS patients with a residual TG after PCI and stent implantation have a significantly higher risk of long-term cardiovascular death. These results might be useful in improving risk stratification for ACS patients and support the need of a tailored antithrombotic therapy.

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Section: Discussionsupporting

confidence: 77%

Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention

Attanasio

Marcucci

Gori

et al. 2016

Thrombosis Research

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“…The study designs and results of individual studies have been published previously. [17][18][19][20][21][22][23][24][25][26][27] Among all studies included, the baseline BMI was calculated with the use of weight and height measured at enrollment and data on adverse cardiovascular events and mortality were prospectively collected. These studies contain information on patient demographics, cardiac or coexisting risk factors, clinical manifestations, left ventricular function, angiographic and procedural characteristics, and in-hospital and follow-up outcomes.…”

Section: Study Population and Proceduresmentioning

confidence: 99%

Association of Body Mass Index With Major Cardiovascular Events and With Mortality After Percutaneous Coronary Intervention

Park¹,

Kim²,

Yun³

et al. 2013

Circ: Cardiovascular Interventions

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Background-Conflicting data exist regarding the relation between body mass index (BMI) and cardiovascular events and mortality after percutaneous coronary intervention. Methods and Results-We performed pooled analyses to evaluate the association between BMI (weight in kilograms divided by the square of the height in meters) and the risks of major cardiovascular events (defined as death from cardiovascular causes, nonfatal myocardial infarction, stent thrombosis, or stroke) and death among 23 181 patients from 11 prospective percutaneous coronary intervention studies. Overall, mean (±SD) BMI was 24.9±3.0. During follow-up (median, 2.1 years), 2381 patients had a major cardiovascular event, and 1004 patients died. After adjusting covariates, there was an inverse relationship between BMI and adverse outcomes. With a BMI of 22.5 to 24.9 as the reference category, the risk of major cardiovascular events was elevated among patients with a lower BMI (by a factor of 1.52 for a BMI <18.5; 1.05 for a BMI of 18.5-19.9; 1.03 for a BMI of 20.0-22.4); by contrast, the risk declined among patients with a higher BMI (by a factor of 0.97 for a BMI of 25.0-27.4; 0.97 for a BMI of 27.5-29.9; and 0.78 for a BMI of ≥30.0). In general, the hazard ratios for deaths were similar. Conclusions-Among patients undergoing percutaneous coronary intervention, a low BMI was associated with increased risks of major cardiovascular events and death. However, there were no excess risks of these events associated with a high BMI. (Circ Cardiovasc Interv. 2013;6:146-153.)

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“…Inflammation has been extensively studied in the pathogenesis and risk assessment of patients with suspected or known coronary artery disease, and elevated levels of C-reactive protein (CRP) have been consistently associated with an elevated risk for coronary artery disease as well as worse outcomes in patients with coronary stenting [10–15]. On the basis of these previous findings, we hypothesized that elevated CRP is associated with heightened plasma clot strength measured by TEG in individuals undergoing coronary stenting on dual anti-platelet therapy.…”

Section: Introductionmentioning

confidence: 99%

C-reactive protein and fibrin clot strength measured by thrombelastography after coronary stenting

Kreutz

Owens

Breall

et al. 2013

Blood Coagulation &Amp; Fibrinolysis

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Inflammation is implicated in the progression of coronary artery disease and the molecular processes of inflammation and thrombosis are closely intertwined. Elevated levels of C-reactive protein (CRP) have been associated with an elevated risk of adverse ischaemic events after coronary stenting and hypercoagulability. Heightened whole blood clot strength measured by thrombelastography (TEG) has been associated with adverse ischaemic events after stenting. We intended to examine the relationship of CRP to plasma fibrin clot strength in patients after coronary stenting. Plasma fibrin clot strength was measured by TEG in 54 patients 16–24 h after undergoing elective percutaneous coronary intervention (PCI). Coagulation was induced in citrated plasma by addition of kaolin and CaCl2. Plasma levels of CRP and fibrinogen were measured by enzyme-linked immunoassay. Increasing quartiles of CRP were associated with increasing levels of maximal plasma fibrin clot strength measured by TEG (P < 0.001) and increasing BMI (P =0.04). Patients in the highest quartile of CRP had significantly higher maximal fibrin clot strength (G) than the patients in the lowest quartile (G: 3438 ± 623 vs. 2184 ± 576 dyn/cm2, P < 0.0001). Fibrinogen concentration was not significantly different across quartiles of CRP (P =0.97). Patients with established coronary artery disease undergoing coronary stenting who have elevated CRP after PCI exhibit heightened maximal plasma fibrin clot strength as compared with those with low CRP. Thrombotic risk associated with elevated CRP may be linked to procoagulant changes and high tensile fibrin clot strength independent of fibrinogen concentration.

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A Point-of-Care Platelet Function Assay and C-Reactive Protein for Prediction of Major Cardiovascular Events After Drug-Eluting Stent Implantation

Cited by 64 publications

References 28 publications

Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention

Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention

Association of Body Mass Index With Major Cardiovascular Events and With Mortality After Percutaneous Coronary Intervention

C-reactive protein and fibrin clot strength measured by thrombelastography after coronary stenting

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