Clinical Significance of Baseline Platelet Reactivity in Patients With Acute Coronary Syndrome

Sedky, Hebatallah Adel; Elsewefy, Dahlia Ahmed; Saad, Abeer A.; Ahmed, Mohamed; El-Maraghy, Heba M. A.

doi:10.1177/1076029612439341

Cited by 3 publications

(2 citation statements)

References 14 publications

(23 reference statements)

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“…Of interest, it has been recently suggested that platelets in ACS are potentially preconditioned to a higher degree of reactivity on the transcriptional level and that changes of the mRNA pool might mediate an increased platelet prothrombotic potential in this setting (13). Indeed, NSTEMI patients proved to have enhanced baseline platelet function than patients with UA and normal subjects (14). Accordingly, Tantry et al (15), by analysing the relation of platelet reactivity, hypercoagulability and inflammation in various stages of coronary artery disease (CAD) acuity, observed an overall increase in all measurements from a clinically stable to an unstable disease state, and highlighted the role of platelets in plaque destabilisation.…”

Section: Platelet Involvement In Acsmentioning

confidence: 99%

Biomarkers of platelet activation in acute coronary syndromes

Ferroni

Riondino²,

Vazzana

et al. 2012

Thromb Haemost

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The most convincing evidence for the participation of platelets in arterial thrombosis in humans comes from studies of platelet activation in patients with acute coronary syndromes (ACS) and from trials of antiplatelet drugs. Both strongly support the concept that repeated episodes of platelet activation over the thrombogenic surface of a vulnerable plaque may contribute to the risk of death from coronary causes. However, the relation of in vivo platelet activation and adverse clinical events to results of platelet function tests remains largely unknown. A valuable marker of in vivo platelet activation should be specific, unaltered by pre-analytical artefacts and reproducibly measured by easily performed methods. This article describes current biomarkers of platelet activation in ACS, reviews their advantages and disadvantages, discusses their potential pitfalls, and demonstrates emerging data supporting the positive clinical implications of monitoring in vivo platelet activation in the setting of ACS.

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Section: Platelet Involvement In Acsmentioning

confidence: 99%

Biomarkers of platelet activation in acute coronary syndromes

Ferroni

Riondino²,

Vazzana

et al. 2012

Thromb Haemost

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“…14 Residual platelet activity may be associated with adverse cardiovascular events in patients with ACS. 5,[15][16][17] In our study, patients who experienced death, MI, or CVA had significantly higher RPA than patients who did not experience (3 agonists resulting in P < .05; Table 5). The cutoff values (Table 6) of impedance method generated from ROC showed optimal NPVs (96% * 97%) and poor PPVs (16%-29%), suggesting that RPA acquired from impedance method has high exclusionary predictive value for the occurrence of major clinical events in patients with ACS.…”

Section: Discussionmentioning

confidence: 47%

Monitoring Residual Platelet Activity Among Patients With Acute Coronary Syndrome

Zhang

2012

Clin Appl Thromb Hemost

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Several medicines are currently used to inhibit the platelet activity. We aim to monitor the residual platelet activity (RPA) despite antiplatelet therapy and assess its relationship with major adverse events. The impedance platelet aggregation was employed to determine RPA. Totally, 202 patients with acute coronary syndrome (ACS) were followed up for 10 months for major clinical events of myocardial infarction, cerebrovascular accident (CVA), and all cause mortality, and RPA after clopidogrel loading was assessed in 30 patients. The RPA at 2 hours after 300 mg clopidogrel loading was 1 Ω (± 2.3 Ω) induced by adenosine diphosphate. Residual platelet activity of patients who experienced death, MI, or CVA was significantly higher than those who did not experience (P < .05). Cutoff values of RPA showed optimal negative predictive values (96%-97%) and poor positive predictive values (16%-29%). Therefore, RPA monitored by whole blood impedance platelet aggregation may have high exclusionary predictive value for the occurrence of major clinical events in patients with ACS.

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