Impact of Platelet Reactivity on Clinical Outcomes After Percutaneous Coronary Intervention

Brar, Somjot; Berg, Jurriën Ten; Marcucci, Rossella; Price, Matthew J.; Valgimigli, Marco; Kim, Hyo–Soo; Patti, Giuseppe; Breet, Nicoline J.; DiSciascio, Germano; Cuisset, Thomas; Dangas, George

doi:10.1016/j.jacc.2011.06.059

Cited by 374 publications

(81 citation statements)

References 27 publications

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“…34,35 Also, the conducted trials in the cardiology literature are designed to measure reduction in thromboembolic events. 36 To our knowledge, no reports on "over-antiplatelet inhibition" and increased hemorrhagic complications have been reported in the endovascular literature.…”

Section: Delayed Ipsilateral Iph Does Not Appear To Be Related To Thementioning

confidence: 96%

Delayed Ipsilateral Parenchymal Hemorrhage Following Flow Diversion for the Treatment of Anterior Circulation Aneurysms

Cruz¹,

Chow²,

O’Kelly³

et al. 2012

AJNR Am J Neuroradiol

159

130

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Section: Delayed Ipsilateral Iph Does Not Appear To Be Related To Thementioning

confidence: 96%

Delayed Ipsilateral Parenchymal Hemorrhage Following Flow Diversion for the Treatment of Anterior Circulation Aneurysms

Cruz¹,

Chow²,

O’Kelly³

et al. 2012

AJNR Am J Neuroradiol

159

130

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“…74 Despite these associations, the clinical usefulness of platelet function testing has been disputed, frequently based on misapplication of statistical measures that are more appropriately suited for the evaluation of diagnostic tests, such as sensitivity and specificity, not prognostic indicators, such as odds ratios or HR, which describe the multiplicative risk of the condition or hazard. 75 Multivariate models are frequently used to evaluate whether the test is an independent predictor of the outcome.…”

Section: Evaluating the Clinical Usefulness Of Platelet Function Testmentioning

confidence: 99%

Platelet-Mediated Thrombosis

Gurbel

Jeong

Navarese

et al. 2016

Circulation Research

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The pivotal role that platelets play in thrombosis and resultant ischemic event occurrences in patients with high-risk coronary artery disease is well established. This role provides the fundamental basis for the current wide implementation of dual antiplatelet therapy with aspirin and a P2Y 12 receptor inhibitor. The development of user friendly point-of-care methods to assess platelet reactivity to adenosine diphosphate has increased the frequency of platelet function testing in clinical practice. Recent large observational studies have established an independent relation between the results of point-of-care platelet function testing and clinical event occurrence in patients undergoing coronary artery stenting. However, prospective, randomized trials have failed to demonstrate that personalized antiplatelet therapy based on point-of-care assessment of platelet function is effective in reducing ischemic event occurrences. Important limitations were associated with these trials. In addition, the concept of a therapeutic window of P2Y 12 receptor reactivity with an upper threshold associated with ischemic event occurrence and a lower threshold associated with bleeding has also been proposed. In the absence of strong prospective evidence to support personalized antiplatelet therapy, clinical decision making about antiplatelet therapy rests on the large body of observational data and the fundamental importance of platelet physiology in catastrophic event occurrence in patients with high-risk coronary artery disease.

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“…In the past, biochemical signs of coagulation activation in the acute phase of unstable angina or acute myocardial infarction (AMI) were demonstrated [1,2] and blood clotting activation markers were found to be independent risk factors for recurrence and long-term mortality [3][4][5][6]. In the last years the diffuse use of PCI and stenting stimulated several studies investigating primarily the role of platelet hyper-reactivity in determining clinical outcome [7,8]. On the other hand, scarce data are available on the possible role of blood clotting activation on the prognosis of ACS patients, in the era of PCI and stenting on the top of dual antiplatelet therapy.…”

Section: Introductionmentioning

confidence: 99%

Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention

Attanasio

Marcucci

Gori

et al. 2016

Thrombosis Research

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Introduction: Thrombin generation (TG) is a central step of the coagulation system involved in hemostatic and thrombotic roles. Scarce data evaluating in the acute phase the association between TG and the risk of cardiovascular death of acute coronary syndrome (ACS) patients are available, in the era of percutaneous coronary intervention (PCI) and stenting with the use of dual antiplatelet treatment. Conclusions: ACS patients with a residual TG after PCI and stent implantation have a significantly higher risk of long-term cardiovascular death. These results might be useful in improving risk stratification for ACS patients and support the need of a tailored antithrombotic therapy.

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Impact of Platelet Reactivity on Clinical Outcomes After Percutaneous Coronary Intervention

Abstract: In this collaborative meta-analysis, the level of on-treatment platelet reactivity according to the P2Y(12) assay is associated with long-term cardiovascular events after percutaneous coronary intervention, including death, MI, and stent thrombosis.

Cited by 374 publications

References 27 publications

Delayed Ipsilateral Parenchymal Hemorrhage Following Flow Diversion for the Treatment of Anterior Circulation Aneurysms

Delayed Ipsilateral Parenchymal Hemorrhage Following Flow Diversion for the Treatment of Anterior Circulation Aneurysms

Platelet-Mediated Thrombosis

Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention

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