Platelet reactivity and cardiovascular events after percutaneous coronary intervention in patients with stable coronary artery disease: the Stent Thrombosis In Belgium (STIB) trial

Legrand, Victor; Cuisset, Thomas; Chenu, Patrick; Vrolix, M.; Martinez, Christophe; Dens, Joseph; Gach, Olivier; Boland, Jean; Claeys, Marc J.; Magné, Julien; Barbato, Emanuele; Wijns, William

doi:10.4244/eijv10i2a34

Cited by 20 publications

(11 citation statements)

References 31 publications

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“…One-month results of the STIB trial showed that HPR was not predictive of early ischaemic events in patients with stable angina undergoing planned PCI, although HPR to clopidogrel was observed in 50% of these patients using the point-of-care VerifyNow® test 4 . These data contrast with the observations made in patients undergoing PCI for unstable coronary syndromes 5 .…”

Section: Although Clinical Value and Impact Of Individuallymentioning

confidence: 97%

The STIB score: a simple clinical test to predict clopidogrel resistance

et al. 2015

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Section: Although Clinical Value and Impact Of Individuallymentioning

confidence: 97%

The STIB score: a simple clinical test to predict clopidogrel resistance

et al. 2015

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“…Therefore, a strong and broad effort is ongoing to identify reliable biomarkers indicative of future major adverse clinical events (MACE). Unfortunately, in real-life clinical scenarios, the practical utilization of predictive models is quite limited and many reports are pessimistic, suggesting marked discrepancies between interventional cardiologists' estimates and the established theoretical prediction models, scores or biomarkers [3,4,5]. Furthermore, the data are very scarce with regard to the potential association of antiplatelet therapy and future MACE predictions.…”

Section: Introductionmentioning

confidence: 98%

Independent Predictors of Major Adverse Events following Coronary Stenting over 28 Months of Follow-Up

et al. 2015

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Background: Despite recent advances in stent design and constantly improving protective pharmacological strategies, complications and adverse events following percutaneous coronary interventions (PCI) are still major factors influencing morbidity and mortality. Therefore, predicting secondary vascular occlusions represents an unmet medical need. Objective: The aim of our study was to triage clinical and laboratory predictors of major adverse clinical events (MACE) following coronary stenting. Methods: This was a prospective, case-controlled, single-center study, which included 94 consecutive patients with documented coronary disease who underwent PCI with drug-eluting stent (DES) implantation. All patients received dual antiplatelet therapy with aspirin and clopidogrel. Numerous clinical characteristics and laboratory biomarkers were assessed before stenting and were correlated with poststenting MACE over the mean follow-up of 28 months. MACE included death, nonfatal myocardial infarction, target vessel revascularisation, stroke, stent thrombosis, angina recurrence and instent restenosis. Results: Twenty-three patients experienced MACE. Independent MACE predictors after PCI with DES implantation were antecedent diabetes mellitus (RR = 0.45; 95% CI 0.20-0.97; p = 0.045), prior thrombolytic therapy (RR = 0.42; 95% CI 0.27-0.83; p = 0.039), baseline plasminogen activator inhibitor -1 (PAI-1; p = 0.008) and plasma von Willebrand factor (vWF) activity (p = 0.007). Other clinical characteristics and laboratory indices showed no correlation with MACE. Conclusions: Background diabetes mellitus, prior thrombolytic therapy, PAI-1 and vWF prestenting activity may be useful for MACE prediction over 28 months of follow-up.

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“…Strong data suggest that aspirin-resistant patients have a 4-fold greater risk of suffering from stroke [5,17] . Therefore, further studies will have to evaluate the place of APD efficacy testing and APD reinforcement in the specific context of acute or chronic inflammatory processes.…”

Section: Discussionmentioning

confidence: 99%

Interest of Antiplatelet Drug Testing after an Acute Ischemic Stroke

Coignion

Poli²,

Sagnier

et al. 2015

Eur Neurol

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Background: Stroke occurrence despite chronic antiplatelet drug (APD) treatment is frequent. We aimed at evaluating the relevance of platelet aggregation testing in the identification of stroke etiology in this context. Methods: Patients admitted for a suspected acute ischemic stroke, while under APD (aspirin and/or clopidogrel), were prospectively included. The efficacy of the APD was evaluated using a Multiplate™ assay. Resistance was confirmed using light transmission aggregometry. A standardized diagnostic work-up was performed to identify stroke mechanism according to the TOAST and the ASCO classifications. We evaluated the influence of APD functional status on stroke severity and identified potential determinants of resistance. Results: APD resistance was observed in 53 of the 287 patients (18.5%). No difference in stroke mechanism depending on APD efficacy was observed. Patients sensitive to APD had less severe initial stroke severity (mean National Institutes of Health Stroke Scale 3.9 ± 5.6 vs. 7.2 ± 6.8; p < 0.01). Main determinants for APD resistance were a worse control of the diabetes and higher baseline levels of inflammation (mean CRP 26.4 ± 56.0 vs. 9.3 ± 21.0; p < 0.01). Conclusions: Platelet function testing does not provide orientation concerning stroke mechanism in patients who were previously on APDs. However, the high frequency of APD resistance and its association with inflammation and stroke severity are confirmed.

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Platelet reactivity and cardiovascular events after percutaneous coronary intervention in patients with stable coronary artery disease: the Stent Thrombosis In Belgium (STIB) trial

Cited by 20 publications

References 31 publications

The STIB score: a simple clinical test to predict clopidogrel resistance

The STIB score: a simple clinical test to predict clopidogrel resistance

Independent Predictors of Major Adverse Events following Coronary Stenting over 28 Months of Follow-Up

Interest of Antiplatelet Drug Testing after an Acute Ischemic Stroke

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