open access

Vol 65, No 1 (2007)
Other
Published online: 2007-01-25
Submitted: 2012-12-28
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Original article
Persistent platelet activation is related to very early cardiovascular events in patients with acute coronary syndromes

Łukasz A. Małek, Mateusz Śpiewak, Krzysztof J. Filipiak, Marcin Grabowski, Monika Szpotańska, Marek Rosiak, Renata Główczyńska, Tomasz Imiela, Zenon Huczek, Grzegorz Opolski
Kardiol Pol 2007;65(1):40-45.

open access

Vol 65, No 1 (2007)
Other
Published online: 2007-01-25
Submitted: 2012-12-28

Abstract


Introduction: Persistent platelet function while on antiplatelet therapy affects outcomes in patients with acute coronary syndromes (ACS).
Aim: To evaluate whether platelet reactivity measured by collagen-epinephrine (CEPI) or collagen-ADP (CADP) closure times (CT) with Platelet Function Analyzer 100® (PFA-100) is related to very early, in-hospital cardiovascular events in patients with ACS.
Methods: The study included 91 patients with ACS undergoing percutaneous coronary intervention (PCI) with stent implantation who were treated with aspirin and clopidogrel. Patients were stratified in accordance with both CEPI-CT (<190 s or >190 s), reflecting aspirin resistance, and our own cut-off point for CADP-CT measured at a mean of 6 days after admission. In-hospital events included re-infarction, cardiac arrest, recurrent angina, severe arrythmias, pulmonary oedema and cardiogenic shock.
Results: Patients were divided into 4 study groups: group 1 with CADP-CT <104 s (n=10, 11.0%), group 2 with CEPI-CT <190 s (n=10, 11.0%), group 3 with CADP-CT <104 s and CEPI-CT <190 s (n=9, 9.9%) and a control group with both CT values above the cut-off limits (n=62, 68.1%). The baseline clinical characteristics and received treatment of each subgroup were similar. A test for a trend between controls, group 1 or 2 and group 3 disclosed statistical significance (p <0.001). When analysed separately, only patients from group 3 had a higher incidence of negative outcomes compared to controls (p <0.005; relative risk RR – 9.0; 95% CI 2.4-33.9).
Conclusions: Enhanced platelet function after PCI when measured under high shear rates by both PFA-100® cartridges is independently associated with the most unfavourable in-hospital clinical outcome.

Abstract


Introduction: Persistent platelet function while on antiplatelet therapy affects outcomes in patients with acute coronary syndromes (ACS).
Aim: To evaluate whether platelet reactivity measured by collagen-epinephrine (CEPI) or collagen-ADP (CADP) closure times (CT) with Platelet Function Analyzer 100® (PFA-100) is related to very early, in-hospital cardiovascular events in patients with ACS.
Methods: The study included 91 patients with ACS undergoing percutaneous coronary intervention (PCI) with stent implantation who were treated with aspirin and clopidogrel. Patients were stratified in accordance with both CEPI-CT (<190 s or >190 s), reflecting aspirin resistance, and our own cut-off point for CADP-CT measured at a mean of 6 days after admission. In-hospital events included re-infarction, cardiac arrest, recurrent angina, severe arrythmias, pulmonary oedema and cardiogenic shock.
Results: Patients were divided into 4 study groups: group 1 with CADP-CT <104 s (n=10, 11.0%), group 2 with CEPI-CT <190 s (n=10, 11.0%), group 3 with CADP-CT <104 s and CEPI-CT <190 s (n=9, 9.9%) and a control group with both CT values above the cut-off limits (n=62, 68.1%). The baseline clinical characteristics and received treatment of each subgroup were similar. A test for a trend between controls, group 1 or 2 and group 3 disclosed statistical significance (p <0.001). When analysed separately, only patients from group 3 had a higher incidence of negative outcomes compared to controls (p <0.005; relative risk RR – 9.0; 95% CI 2.4-33.9).
Conclusions: Enhanced platelet function after PCI when measured under high shear rates by both PFA-100® cartridges is independently associated with the most unfavourable in-hospital clinical outcome.
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Keywords

PFA-100®; acute coronary syndrome; antiplatelet agents; cardiovascular events

About this article
Title

Original article
Persistent platelet activation is related to very early cardiovascular events in patients with acute coronary syndromes

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 1 (2007)

Pages

40-45

Published online

2007-01-25

Bibliographic record

Kardiol Pol 2007;65(1):40-45.

Keywords

PFA-100®
acute coronary syndrome
antiplatelet agents
cardiovascular events

Authors

Łukasz A. Małek
Mateusz Śpiewak
Krzysztof J. Filipiak
Marcin Grabowski
Monika Szpotańska
Marek Rosiak
Renata Główczyńska
Tomasz Imiela
Zenon Huczek
Grzegorz Opolski

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