A time course study of high on treatment platelet reactivity in acute coronary syndrome male patients on dual antiplatelet therapy. Issue 3 (September 2015)

• Record Type: Journal Article
• Authors: Fabbri, Alessia; Marcucci, Rossella; Gori, Anna Maria; Giusti, Betti; Paniccia, Rita; Balzi, Daniela; Barchielli, Alessandro; Valente, Serafina; Giglioli, Cristina; Abbate, Rosanna; Gensini, Gian Franco
• Is Part Of: Thrombosis research. Volume 136:Issue 3(2015)
• Page Start: 613
• Page End: 619
• Publication Date: 2015-09
• Subjects: Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2015.06.040
• Languages: English
• ISSNs: 0049-3848

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0010">Introduction</title> <p id="sp0005">Limited data are available on the natural history of high on treatment platelet reactivity (HPR) by arachidonic acid and ADP - markers of unfavorable prognosis in acute coronary syndrome patients -.</p> </sec> <sec> <title id="st0015">Material and methods</title> <p id="sp0010">In a cohort of acute coronary syndrome male patients (n = 101), we evaluated the time-course of HPR by ADP (platelet aggregation by 10 μM ADP ≥ 70%) and arachidonic acid (platelet aggregation by 1 mmol arachidonic acid ≥ 20%) measuring platelet function in the acute phase (T0), at 6 months (T1) and 1 year (T2).</p> </sec> <sec> <title id="st0020">Results</title> <p id="sp0015">We identified <italic>persistent</italic> (HPR at T0, T1 and T2), <italic>acute non persistent</italic> (HPR only at T0), and <italic>late</italic> (HPR only at T1 or T2). Patients with <italic>persistent</italic> HPR by ADP were more frequently with higher values of BMI. Patients carrying CYP2C19*2 variant were more prevalent in the group of <italic>persistent</italic> HPR (33%). Significant higher values of immature platelet fraction and high immature platelet fraction at 6 and 12 months and mean platelet volume were present in patients with <italic>late</italic> HPR. Immature platelet fraction was the only variable significantly associated with late HPR by ADP at multivariate analysis (OR = 1.6 (1.08-2.3), p = 0.016). Patients with <italic>persistent</italic> HPR by arachidonic acid were more frequently diabetics. Immature platelet fraction at 6 months and high immature platelet fraction at 6 and 12 months were the parameters associated with late HPR by AA (OR = 1.4 (1.0-1.9), p = 0.036; OR = 1.5 (1.08-2.4), p = 0.05; OR = 4.9 (1.3-18.8), p = 0.018, respectively).</p> </sec> <sec> <title id="st0025">Conclusions</title> <p id="sp0020">About 25% of 101 patients has <italic>persistent</italic> HPR; they are more frequently diabetics, overweight or carriers of CYP2C19*2. The occurrence of an inflammatory state, indicated by the increase of immature platelet fraction, is associated with the occurrence of <italic>late</italic> HPR.</p> </sec> </abstract>