Altered platelet reactivity, coagulation, endothelial and inflammatory markers early after smoking cessation verified with cotinine plasma concentration

Ramotowski, Bogumił; Undas, Anetta; Budaj, Andrzej

doi:10.1007/s11239-023-02819-5

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…They finally found an increase in platelet reactivity and the risk of thrombotic complications in CAD patients following PCI after smoking cessation. 16 However, no one has yet to look specifically at smokers and genetic predisposition for clopidogrel high in‐treatment platelet reactivity. We investigated this issue through sub‐analysis of the Personalized Antithrombotic Therapy for Coronary Heart Disease after PCI (PATH‐PCI) study in China, to examine the effect of smoking on the safety and efficacy of personalized antiplatelet therapy (PAT) in chronic coronary syndrome (CCS) patients after PCI.…”

Section: Introductionmentioning

confidence: 99%

Smoking and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: A substudy from the randomized PATH‐PCI trial

Pan,

Wu,

Deng

et al. 2024

Clinical Cardiology

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BackgroundThis is a sub‐analysis of the Personalized Antithrombotic Therapy for Coronary Heart Disease after PCI (PATH‐PCI) trial in China to explore the relationship between smoking and outcomes following personalized antiplatelet therapy (PAT) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI).MethodsAs a single‐center, prospective, randomized controlled and open‐label trial, the PATH‐PCI trial randomized CCS patients undergoing PCI into standard group or personalized group guided by a novel platelet function test (PFT), from December 2016 to February 2018. All patients were divided into smokers and nonsmokers according to their smoking status. Subsequently, we underwent a 180‐day follow‐up evaluation. The primary endpoint was the net adverse clinical events (NACE).ResultsRegardless of smoking status, in the incidence of NACE, there was a reduction with PAT but that the reductions are not statistically significant. In the incidence of bleeding events, we found no statistically significant difference between two groups (smokers: 2.0% vs. 1.4%, HR = 1.455, 95% confidence interval [CI]: 0.595−3.559, p = .412; nonsmokers: 2.2% vs. 1.8%, HR = 1.228, 95% CI: 0.530−2.842, p = .632). In smokers, PAT reduced major adverse cardiac and cerebrovascular events (MACCE) by 48.7% (3.0% vs. 5.9%, HR = 0.513, 95% CI: 0.290−0.908, p = .022), compared with standard antiplatelet therapy (SAT). PAT also reduced the major adverse cardiovascular events (MACE) but there was no statistically difference in the reductions (p > .05). In nonsmokers, PAT reduced MACCE and MACE by 51.5% (3.3% vs. 6.7%, HR = 0.485, 95% CI: 0.277−0.849, p = .011) and 63.5% (1.8% vs. 4.9%, HR = 0.365, 95% CI: 0.178−0.752, p = .006), respectively. When testing p‐values for interaction, we found there was no significant interaction of smoking status with treatment effects of PAT (pint‐NACE = .184, pint‐bleeding = .660).ConclusionRegardless of smoking, PAT reduced the MACE and MACCE, with no significant difference in bleeding. This suggests that PAT was an recommendable regimen to CCS patients after PCI, taking into consideration both ischemic and bleeding risk.

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Section: Introductionmentioning

confidence: 99%

Smoking and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: A substudy from the randomized PATH‐PCI trial

Pan,

Wu,

Deng

et al. 2024

Clinical Cardiology

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Hemostasis parameters in patients with arterial hypertension, multifocal atherosclerosis and risk factors

Vedenskaya,

Smolenskaya,

Grachev

et al. 2024

Klinicist

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Aim. To determine the features of hemostasis system disorders and the possibility of their correction in patients with arterial hypertension (AH) and multifocal atherosclerotic lesions (MFA) with risk factors indicated.Materials and methods. The study included 135 patients (mean age 53.7 ± 7.76 years), including 80 patients with controlled AH stage and II (group 1) and 55 patients with controlled AH stage III who had ischemic stroke (group 2). Among all patients studied, 33 patients (24.4 %) were smokers. All 135 patients received comparable antihypertensive, antiplatelettherapy (acetylsalicylic acid at a dose of 100 mg/day), had MFA and target lipid spectrum values.Results. Procoagulant shifts are noted already in patients with AH stage I and II, especially in the presence of smoking. Such indices of global thrombodynamics test as initial clot growth rate, average clot growth rate, clot size significantly exceed the reference values and indicate high prothrombogenic potential in patient with AH and MFA. Prescription of dual antiplatelet therapy allows normalization of identified disorders. Presence of risk factors (smoking) aggravates existing hemostasis disorders in patients with AH and MFA.Conclusion. Smoking cessation, optimization of risk factors and complex antihypertensive, hypolipidemic and antithrombotic therapy are the basis of treatment of patients with AH and MFA and can be considered as priority measures to reduce morbidity and mortality in this patient population.

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The Coagulology Section of the Polish Societyof Laboratory Diagnostics recommendations on the plateletreactivity test. 2023

Golański,

Raszeja-Specht

2023

Diagn Lab.

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Platelet reactivity testing is used for a wide variety of clinical purposes; firstly, to study plateletdysfunction in acute bleeding and diagnosis of platelet disorders in patients with long-term bleeding tendency, and secondly, to study the effectiveness of antiplatelet therapy in patientswith increased risk of thromboembolism. A new direction of research is platelet phenotyping.To provide an overview of contemporary platelet function testing, this review summarizes themost commonly used tests in Poland, including their advantages, disadvantages, and clinicalutility. The review also discusses preanalytical variables that should be considered whenexamining platelet function. Finally, we concluded future directions for the study of plateletfunction for clinical or research purposes.

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Altered platelet reactivity, coagulation, endothelial and inflammatory markers early after smoking cessation verified with cotinine plasma concentration

Cited by 3 publications

References 39 publications

Smoking and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: A substudy from the randomized PATH‐PCI trial

Smoking and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: A substudy from the randomized PATH‐PCI trial

Hemostasis parameters in patients with arterial hypertension, multifocal atherosclerosis and risk factors

The Coagulology Section of the Polish Societyof Laboratory Diagnostics recommendations on the plateletreactivity test. 2023

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