High On-Treatment Platelet Reactivity Predicts Cardiac Events in Patients with Drug-Eluting Stents

Villacorta, Aline Sterque; Villacorta, Humberto; Batista, Marcos J. S.; Gomes, Renato Villela; Macedo, Luiz Augusto; Helmuth, Bruno; Mesquita, Evandro Tinoco

doi:10.5935/abc.20130044

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…All articles included were published between 2000 and 2020, referring to studies conducted between 1993 and 2017. Most studies were conducted in Brazil [ 3 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 ]. Six studies were conducted in Argentina [ 59 60 61 62 63 64 ], four in Chile [ 65 66 67 68 ], four in Colombia [ 69 70 71 72 ], three in Uruguay [ 73 74 75 ] and two were multi-country studies conducted in Argentina, Brazil, Chile and Colombia [ 12 ] and Brazil and Suriname [ 76 ].…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Marzà-Florensa

Drotos

Gulayin

et al. 2022

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Background: Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but information from South America is scarce. Methods: We conducted a systematic review on prevalence of secondary prevention medication in South America. We pooled prevalence estimates, analysed time-trends and guideline compliance, and identified factors associated with medication use with meta-regression models. Results: 73 publications were included. Medication prevalence varied by class: beta-blockers 73.4%(95%CI 66.8%–79.1%), ACEI/ARBs 55.8%(95%CI 49.7%–61.8), antiplatelets 84.6%(95%CI 79.6%–88.5%), aspirin 85.1%(95%CI 79.7%–89.3%) and statins 78.9%(95%CI 71.2%–84.9%). The use of beta-blockers, ACEI/ARBs and statins increased since 1993. Ten publications reported low medication use and nine reported adequate use. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres. Conclusion: Cardioprotective medication use has increased, but could be further improved particularly in community settings.

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Section: Resultsmentioning

confidence: 99%

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Marzà-Florensa

Drotos

Gulayin

et al. 2022

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“…This prevalence is moderately high when compared with other studies that demonstrate HPR ranging from 5% and 21% up to 55% depending on the race, type of intervention, and assay for platelet reactivity. 6 –8…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Change to New P2Y12 Receptor Antagonists in Patients High on Treatment Platelet Reactivity Undergoing Percutaneous Coronary Intervention

Robledo-Nolasco

Zaballa-Contreras

et al. 2014

Clin Appl Thromb Hemost

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Selective intensification of platelet inhibition may improve high on treatment platelet reactivity (HPR). We evaluated the efficacy of dual-antiplatelet therapy, including clopidogrel (CPG), compared to new P2Y12-receptor antagonists in patients with HPR undergoing percutaneous coronary intervention, regarding the outcome of composite major adverse cardiac events (MACEs, including death, acute coronary syndrome [ACS], and stent restenosis). The presence of HPR (71 of 181 patients) almost doubled the risk of MACEs. The new antiplatelet agent reduced MACEs (45.8%, 26%, and 16.7% for CPG, prasugrel, and ticagrelor [TGL]; RR 0.36; 0.13-0.98, P = .03, TGL), specifically in patients with ACS. Failure to reduce HPR after the antiplatelet change and diabetes were independent predictors for MACEs. The HPR was early and effectively reduced after changing the antiplatelet therapy, but the intensity of this reduction did not significantly decrease the risk of MACEs. These findings support the benefit of HPR-guided intensification of platelet inhibition. Whether the intensity of this reduction improves the patient's clinical outcomes deserves further investigation.

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Intensive atorvastatin improves endothelial function and decreases ADP-induced platelet aggregation in patients with STEMI undergoing primary PCI: A single-center randomized controlled trial

Liu

et al. 2016

International Journal of Cardiology

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High On-Treatment Platelet Reactivity Predicts Cardiac Events in Patients with Drug-Eluting Stents

Abstract: In this study, 55.7% of the patients had high on-treatment platelet reactivity. ADP 5µM >33% was an independent predictor of long-term events.

Cited by 4 publications

References 34 publications

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Efficacy of Change to New P2Y12 Receptor Antagonists in Patients High on Treatment Platelet Reactivity Undergoing Percutaneous Coronary Intervention

Intensive atorvastatin improves endothelial function and decreases ADP-induced platelet aggregation in patients with STEMI undergoing primary PCI: A single-center randomized controlled trial

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