Platelet activation predicts recurrent ischemic events after percutaneous coronary angioplasty: A 6 months prospective study

Gianetti, Jacopo; Parri, Maria Serena; Sbrana, Silverio; Paoli, Fabrizio; Maffei, Stefano; Paradossi, Umberto; Sergio, Berti; Clerico, A.; Biagini, Andrea

doi:10.1016/j.thromres.2005.10.011

Cited by 81 publications

(58 citation statements)

References 26 publications

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“…On the other hand, the PFA-100 test with CADP has been shown to predict MI size and longterm outcome in patients with ACS. [22][23][24][25] Also, in our study lower values of CADP-CT were a signal of harm. The quasi-complete separation of CADP-CT between group 1 and the controls is very unlikely to be accidental.…”

Section: Study Limitationssupporting

confidence: 57%

Coexisting Polymorphisms of P2Y12 and CYP2C19 Genes as a Risk Factor for Persistent Platelet Activation With Clopidogrel

Małek

Kisiel

Śpiewak

et al. 2008

Circ J

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Section: Study Limitationssupporting

confidence: 57%

Coexisting Polymorphisms of P2Y12 and CYP2C19 Genes as a Risk Factor for Persistent Platelet Activation With Clopidogrel

Małek

Kisiel

Śpiewak

et al. 2008

Circ J

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“…Moreover, Gianetti and colleagues demonstrated an independent positive relation of aspirin resistance, estimated by the PFA-100, and 6-mo clinical recurrence of symptoms in 175 patients with stable or unstable coronary artery disease who underwent successful coronary stenting. 6 Another report by Fuchs et al, 7 with a study population of 208 patients with unstable coronary artery disease, also yielded a significant independent association of aspirin resistance, assessed by PFA-100, and major atherothrombotic long-term events.…”

Section: Discussionmentioning

confidence: 88%

The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

Foussas¹,

Zairis²,

Tsirimpis³

et al. 2009

Clinical Cardiology

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Background: Aspirin resistance has been associated with an adverse long-term outcome in patients with atherosclerotic coronary artery disease, but more studies are needed. Hypothesis: The aim of this study was to investigate the impact of aspirin resistance, assessed by the Platelet Function Analyzer-100 (PFA-100) (Dade Behring Inc., Deerfield, Ill., USA) on the long-term prognosis in patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS). Methods: A total of 496 consecutive patients were studied. The 1-y incidence of cardiovascular death was the prespecified study endpoint. The patients were divided, according to the values of PFA-100 collagen epinephrine closure time (CEPI-CT) upon presentation, into aspirin sensitives (those with a PFA-100 CEPI-CT >193 sec) and aspirin resistants (those with a PFA-100 CEPI-CT ≤193 sec). Results: Aspirin resistants were younger (p-value = 0.04), and less frequently hypertensives (p-value = 0.05) or diabetics (p-value = 0.04) than aspirin sensitives. By 1 y, the incidence of cardiovascular deaths in the entire cohort was 12.9% (64/496), and aspirin resistants were at significantly higher risk of cardiovascular death (23.1% versus 9.6%; hazard ratio [HR] = 2.6; 95% confidence interval [CI] = 1.6-4.3; p-value <0.001), than aspirin sensitives. By multivariate Cox regression analysis, aspirin resistance (a PFA-100 CEPI-CT ≤193 sec) was among the most potent predictors of the 1-y incidence of cardiovascular death (HR = 2.8; 95% CI = 1.7-4.6; p-value <0.001). Conclusion: According to the present data, aspirin resistance, assessed by the PFA-100, is an independent predictor of long-term cardiovascular mortality in patients with NSTE-ACS.

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“…Eight studies were eliminated because they were not prospective studies, 4 because they reported only clopidogrel resistance, 2 because they did not evaluate clinical cardiovascular recurrences during the follow-up but only surrogate markers, and 1 because only a meeting abstract was available. As a result, a total of 11 prospective studies were included in the meta-analysis [8][9][10][11][12][13][14][15][16][17][18].…”

Section: Search Resultsmentioning

confidence: 99%

Residual platelet reactivity on aspirin therapy and recurrent cardiovascular events — A meta-analysis

Sofi

Marcucci

Gori

et al. 2008

International Journal of Cardiology

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Background: Recently, a growing body of evidence on the possible role of residual platelet reactivity (RPR) in affecting clinical events has accumulated. The aim of this study was to systematically assess the relationship between RPR on acetylic salicylic acid (ASA) therapy and the occurrence of recurrent events in a meta-analysis of prospective studies. Methods: A systematic literature search of MEDLINE, EMBASE, Science Citation Index, the Cochrane Systematic Review Database and bibliographies of retrieved articles through May 2007 was conducted. Studies were included if they analysed RPR in coronary heart disease patients in relation to the occurrence of adverse coronary events during follow-up. Results: Eleven prospective studies, incorporating 1952 patients with coronary heart disease followed for a time ranging from 6 days to 4 years, met the inclusion criteria. The pooled analysis demonstrated a significantly increased relative risk of adverse clinical events during follow-up for patients with RPR on ASA therapy (RR: 3.11, 95%CI 1.88-5.15; p b 0.0001). Moreover, the association between RPR and cardiovascular recurrences remained to be statistically significant even when subgroup analyses performed according to the duration of follow-up, ASA dosage, characteristics of the study population, and laboratory method were conducted. Conclusions: The present meta-analysis documents a significant association between RPR on ASA treatment and recurrent cardiovascular events. More prospective studies are needed to determine the independent prognostic importance of RPR during aspirin therapy and possible benefit of individually tailored anti-platelet treatment strategies in these patients.

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Platelet activation predicts recurrent ischemic events after percutaneous coronary angioplasty: A 6 months prospective study

Cited by 81 publications

References 26 publications

Coexisting Polymorphisms of P2Y12 and CYP2C19 Genes as a Risk Factor for Persistent Platelet Activation With Clopidogrel

Coexisting Polymorphisms of P2Y12 and CYP2C19 Genes as a Risk Factor for Persistent Platelet Activation With Clopidogrel

The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

Residual platelet reactivity on aspirin therapy and recurrent cardiovascular events — A meta-analysis

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