Discordance Between VASP Phosphorylation and Platelet Aggregation in Defining High On-Clopidogrel Platelet Reactivity After ST-Segment Elevation Myocardial Infarction. (January 2018)

• Record Type: Journal Article
• Authors: Sun, Jing; Yang, Guo-Hong; Liu, Jun-Xiang; Liu, Xin-Lin; Ma, Yong-Qiang; Lu, Rui-Yi; Zhang, Ying-Ying; Chen, Shao-Bo; Zhao, Ji-Hong; Ji, Wen-Jie; Zhou, Xin; Li, Yu-Ming
• Is Part Of: Clinical and applied thrombosis/hemostasis. Volume 24:Number 1(2018)
• Page Start: 47
• Page End: 54
• Publication Date: 2018-01
• Subjects: platelet responsiveness -- percutaneous coronary intervention -- platelet reactivity index; Hemostasis -- Periodicals; Thrombosis -- Periodicals; 616.13
• DOI: 10.1177/1076029617726600
• Languages: English
• ISSNs: 1076-0296

Abstract

To investigate potential clinical characteristics associated with discordance between platelet vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) flow cytometry (FCM) assay and light transmission aggregometry (LTA) in defining high on-clopidogrel platelet reactivity (HPR) after ST-segment elevation myocardial infarction (STEMI). In this study, platelet responsiveness was measured by the above 2 methods simultaneously on day 1 and on day 6 of STEMI onset in 90 consecutive patients who underwent primary percutaneous coronary intervention. The FCM-derived platelet reactivity index and LTA-derived platelet aggregation rate were both significantly reduced after dual antiplatelet therapy on day 6. Multiple variable-adjusted logistic regression analysis revealed that smoking (odds ratio [OR]: 4.507, 95% confidence interval [CI]: 1.123-18.09, P = .034) and onset-to-admission time (per 1 hour increase, OR: 1.196, 95% CI: 1.023-1.398, P = .025) both were independent predictors for the discordance between the 2 methods. Additionally, improved correlation and concordance was observed in nonsmokers compared with smokers. Our data show that smoking and prolonged onset-to-admission time are associated with discordance between platelet VASP-P and LTA in defining HPR after STEMI, which should be considered when planning personalized antiplatelet therapy.