Association of ADP-Induced Whole-Blood Platelet Aggregation with Serum Low-Density Lipoprotein Cholesterol in Patients with Coronary Artery Disease When Receiving Maintenance Ticagrelor-Based Dual Antiplatelet Therapy

Chyrchel, Bernadeta; Kruszelnicka, Olga; Wieczorek-Surdacka, Ewa; Surdacki, Andrzej

doi:10.3390/jcm12134530

Cited by 3 publications

(1 citation statement)

References 79 publications

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“…О влиянии гиперхолестеринемии на агрегацию тромбоцитов и наличие ВОРТ в литературе получены разноречивые данные. Есть работы, в которых не было выявлено связи между уровнем общего холестерина либо холестерина липопротеинов низкой плотности (ЛПНП) и ADP-test у пациентов с ОКС или после ЧКВ на фоне приема статинов и клопидогрела [38,39]. Есть работы, в которых продемонстрирована зависимость между высокими значениями общего холестерина и ЛПНП и ВОРТ на прием клопидогрела [8], есть работы, в которых показана связь между низкими значениями ЛПНП и риском кровотечений у пациентов с ОКС [40].…”

Section: рис 2 Roc-кривая модели для определения норт; Auc -площадь п...unclassified

Analysis of Factors of High and Low Platelet Residual Reactivity During Clopidogel Treatment in the Subacute Period of Myocardial Infarction

Пронько,

Снежицкий,

Копыцкий

2023

Кардиология В Беларуси

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Цель. Оценка факторов, определяющих высокую и низкую остаточную реактивность тромбоцитов (ВОРТ и НОРТ) при приеме клопидогрела у пациентов в подострый период инфаркта миокарда (ИМ). Материалы и методы. Обследовано 405 пациентов с ИМ в возрасте от 31 года до 74 лет, 322 мужчины и 83 женщины. Группа 1 – пациенты с НОРТ – 37 человек, группа 2 – пациенты с оптимальной реактивностью тромбоцитов – 263 человека, группа 3 – пациенты с ВОРТ – 105 человек. Исследования проводились на 12–14-е сутки ИМ: агрегометрия на агрегометре Multiplate (Германия) с несколькими индукторами агрегации, общий анализ крови и тромбоцитарные индексы на гемоанализаторе Sysmex XS-500i (Япония), определение растворимого лиганда CD40 (sСD40L) и sP-селектина, фактора фон Виллебранда (ФВ) и эндотелина-1 – у 145 человек на иммуноферментном анализаторе Sunrise TECAN (Австрия), эндотелийзависимая вазодилатация (ЭЗВД) методом реовазографии на «Импекард-М» (Беларусь) у 345 человек. Результаты. При проведении однофакторного линейного регрессионного анализа выявлены следующие факторы, независимо влияющие на значение ADP-test: возраст (β=–0,36, 95% ДИ –0,58 – –0,16; р=0,0006); продолжительность ИБС (β=–0,4, 95% ДИ –0,76 – –0,04; р=0,028); скорость оседания эритроцитов (СОЭ) (β=0,32, 95% ДИ 0,17–0,47; р=0,00003); количество лейкоцитов (β=1,22, 95% ДИ 0,23–2,21; р=0,015); количество тромбоцитов (β=0,06, 95% ДИ 0,038–0,083; р<0,000001); тромбокрит (β=54,4, 95% ДИ 32,3–76,5; р=0,000002); TRAP-test (β=0,4, 95% ДИ 0,33–0,46; р<0,000001). Для определения вероятности развития ВОРТ и НОРТ были построены уравнения множественной бинарной логистической регрессии. Выводы. Маркерами ВОРТ являются индекс массы тела (ИМТ), курение, СОЭ, количество тромбоцитов и TRAP-test (чувствительность – 74,5%, специфичность – 74,3%, точность – 74,3%, площадь под ROC-кривой – 0,819 (95% ДИ 0,772–0,867) для данной модели). Маркерами НОРТ являются ИМТ, количество тромбоцитов, ширина распределения тромбоцитов по объему (PDW), уровень холестерина и ЭЗВД (чувствительность – 79,17%, специфичность – 78,15%, точность – 78,23%, площадь под ROC-кривой – 0,794 (95% ДИ 0,697–0,892) для данной модели). Purpose. Evaluation of markers that determine high and low residual platelet reactivity (HRPR and LRPR) when taking clopidogrel in patients in the subacute period of myocardial infarction (MI). Materials and methods. 405 patients with MI aged 31 to 74 years, 322 men and 83 women, were examined. Group 1 – patients with LRPR – 37 people, group 2 – patients with optimal platelet reactivity – 263 people, group 3 – patients with HRPR – 105 people. Studies were carried out on the 12–14th day of MI: aggregometry on the Multiplate aggregometer (Germany) with several aggregation inducers, blood test and platelet indices on the Sysmex XS-500i hemoanalyzer, Japan, determination of soluble CD40 ligand (sСD40L) and sP-selectin, von Willebrand factor (VWF) and endothelin-1 – in 145 people on the enzyme immunoassay analyzer Sunrise TECAN, Austria, endothelium-dependent vasodilation (EDVD) by the method of rheovasography on "Impekard-M" (Belarus) in 345 people. Results. When conducting a one-way linear regression analysis, the following factors were identified that independently affect the value of the ADP-test: age (β=–0.36, 95% CI –0.58 – –0.16; p=0.0006); duration of CAD (β=–0.4, 95% CI –0.76 – –0.04; p=0.028); erythrocyte sedimentation rate (ESR) (β=0.32, 95% CI 0.17–0.47; p=0.00003); white blood cell count (β=1.22, 95% CI 0.23–2.21; p=0.015); platelet count (β=0.06, 95% CI 0.038–0.083; p<0.000001); thrombocrit (β=54.4, 95% CI 32.3–76.5; p=0.000002); TRAP-test (β=0.4, 95% CI 0.33–0.46; p<0.000001). Multiple binary logistic regression equations were constructed to determine the probability of developing HRPR and LRPR. Conclusions. HRPR markers are body mass index (BMI), smoking, ESR, platelet count and TRAP-test (sensitivity – 74.5%, specificity – 74.3%, accuracy – 74.3%, area under the ROC-curve – 0.819 (95% CI 0.772–0.867) for this model). LRPR markers are BMI, platelet count, platelet distribution width (PDW), cholesterol level and EDVD (sensitivity – 79.17%, specificity – 78.15%, accuracy – 78.23%, area under the ROC-curve – 0.794 (95% CI 0.697– 0.892) for this model).

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Section: рис 2 Roc-кривая модели для определения норт; Auc -площадь п...unclassified

Analysis of Factors of High and Low Platelet Residual Reactivity During Clopidogel Treatment in the Subacute Period of Myocardial Infarction

Пронько,

Снежицкий,

Копыцкий

2023

Кардиология В Беларуси

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Impact of haemoglobinA1c on platelet reactivity and cardiovascular outcomes in patients undergoing drug-eluting stent implantation

Wu,

Jiang,

Jiang

et al. 2024

Sci Rep

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Associations between hemoglobin A1c levels and platelet reactivity and their impact on outcomes in patients after coronary insertion of drug-eluting stents

wu,

Jiang,

Jiang

et al. 2024

Preprint

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Background Increased hemoglobin A1c levels indicate a poor cardiovascular prognosis; however, the associations between glycemic control, platelet reactivity assessed by thromboelastography (TEG), and outcomes after coronary stenting in the Chinese population are unclear. Our study aimed to determine whether HbA1c levels are related to platelet reactivity after the administration of a loading dose of clopidogrel and aspirin; therefore, there is an effort to intensify antiplatelet treatment in patients with poor glycemic control after percutaneous coronary intervention. Methods HbA1c levels were categorized into 3 groups: <6.5% (n = 1103, 48.12%), 6.5–8.5% (n = 341, 36.9%), and > 8.5% (n = 177, 14.9%). ROC (resistance to clopidogrel, ROC) and ROA (resistance to aspirin) were defined as the ADP (adenosine diphosphate.) inhibition rate of less than 30% and an AA (Arachidonic Acid.) inhibition rate of less than 50% by TEG, respectively. Multivariate Cox regression analysis was performed to evaluate HbA1c levels and the independent impact of the ROC curve on adverse events. Univariate logistic analysis was used to evaluate the associations between HbA1c levels and ROC. A restricted cubic spline was used to explore the nonlinear relationship between HbA1c and MACEs. Receiver operating characteristic analysis was conducted to assess the predictive value of HbA1c for MACEs. Results The incidence of ROC was 9.3% (151 of 1621), whereas that of ROC was 16.5% (268 of 1621). The ROC for each of the 3 groups significantly increased with increasing HbA1c levels [4.3% vs 7.1% vs 10.1%, p = 0.006]; however, the ROA did not [16.4% vs 17.7% vs 14.3%, P = 0.694]. Both HbA1c > 8.5 and 6.5 ≤ HbA1c ≤ 8.5 were significantly associated with ROC. However, after adjustment for other covariables, only the HbA1c > 8.5 subgroup remained significantly associated with ROC (3.356 [1.231, 9.234], p = 0.009). Compared with the HbA1c < 6.5 subgroup, the HbA1c˃8.5 subgroup was significantly associated with nonfatal MI (2.297 [1.275, 4.137], P = 0.006), ischemia-driven revascularization (3.845 [2.082, 7.101], p < 0.001) and MACE (3.142 [2.346, 4.206], < 0.001), but not all-cause mortality (2.371 [0.551, 10.190], 0.246), and remained associated even after fully adjusting for confounders at the 36-month follow-up. When considered a continuous variable, HbA1c had a positive correlation with MACEs, as indicated by the RCS. The AUC of HbA1c for the prediction of 36-month MACEs was 0.636 (0.612, 0.624; P < 0.001). Conclusion In our two-center large-scale study, HbA1c levels were positively correlated with ROC, but the adverse effect on clinical outcomes was driven by elevated HbA1c, which forecasted nonfatal MI and ischemia-driven revascularization, constituting an argument to intensify glycemic control in subjects with diabetes after intracoronary stent placement.

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Association of ADP-Induced Whole-Blood Platelet Aggregation with Serum Low-Density Lipoprotein Cholesterol in Patients with Coronary Artery Disease When Receiving Maintenance Ticagrelor-Based Dual Antiplatelet Therapy

Cited by 3 publications

References 79 publications

Analysis of Factors of High and Low Platelet Residual Reactivity During Clopidogel Treatment in the Subacute Period of Myocardial Infarction

Analysis of Factors of High and Low Platelet Residual Reactivity During Clopidogel Treatment in the Subacute Period of Myocardial Infarction

Impact of haemoglobinA1c on platelet reactivity and cardiovascular outcomes in patients undergoing drug-eluting stent implantation

Associations between hemoglobin A1c levels and platelet reactivity and their impact on outcomes in patients after coronary insertion of drug-eluting stents

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