Combination of P2Y12 reaction unit and percentage of platelet inhibition assessed by VerifyNow P2Y12 assay is a useful predictor of long-term clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Issue 139 (March 2016)

• Record Type: Journal Article
• Authors: Luo, Yu; Li, Jimin; Liu, Xu; Xu, Jianfeng; Ye, Zi; Yao, Yian; Liu, Xuebo; Lai, Yan
• Is Part Of: Thrombosis research. Issue 139(2016)
• Page Start: 114
• Page End: 120
• Publication Date: 2016-03
• Subjects: Platelet reactivity -- Clopidogrel -- Acute coronary syndrome -- Stent; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2016.01.020
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Introduction: High on-treatment platelet reactivity is a well-known risk factor for adverse events in patients undergoing percutaneous coronary intervention (PCI). This study was to investigate the value of a novel platelet reactivity-based system, named the COP-INH (COmbination of P2Y12 reaction unit [PRU] and percentage of platelet inhibition [%INH]), assessed by VerifyNow P2Y12 assay, for predicting the long-term ischaemic events in patients with acute coronary syndrome (ACS) undergoing PCI. Materials and methods: The COP-INH was calculated on the basis of data obtained at 30 days after PCI: patients with both an elevated PRU (≥ 230) and decreased %INH (< 40%) were allocated a score of 2, and patients showing one or neither were allocated a score of 1 or 0, respectively. The primary endpoint was the composite of cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization at 1 year follow-up. The relationship between the COP-INH score and primary endpoint was analyzed. Results: 207 patients were enrolled. Baseline characteristics were similar between patients with COP-INH = 2 and patients with COP-INH = 1 or 0, except for diabetes mellitus (43.8% vs. 21.7%, p = 0.015) and previous coronary artery bypass grafting (CABG) (21.9% vs. 6.86%, p = 0.007). During the observation period, the incidence of major adverse cardiovascular events (MACE) in patients with COP-INH = 2 was significantly higher than patients with COP-INH = 1 or 0 (18.8% vs. 4.6%, p = 0.007). Multivariate analysis of clinical characteristics and platelet reactivity selected by univariate analysis showed that the COP-INH = 2 was an independent predictor of MACE in patients with ACS undergoing PCI (OR 2.745; 95% CI 1.369-9.851; p = 0.024), whereas neither PRU ≥ 230 nor %INH < 40% was. Conclusion: The COP-INH is considered to be a useful predictor of long-term ischaemic events of patients with ACS undergoing PCI. Highlights: We examine the platelet reactivity PRU and %INH in ACS patients undergoing PCI. We investigate the value of COP-INH (COmbination of PRU and %INH) for prognosis. COP-INH = 2 (both elevated PRU and decreased %INH) was independent predictor of MACE. COP-INH is more useful than either PRU or %INH for predicting long term prognosis.