Inflammatory state does not affect the antiplatelet efficacy of potent P2Y12 inhibitors in ACS. (19th May 2021)

• Record Type: Journal Article
• Authors: Biesinger, Benedikt S.; Gasecka, Aleksandra; Perkmann, Thomas; Wojta, Johann; Lesiak, Maciej; Grygier, Marek; Eyileten, Ceren; Postuła, Marek; Filipiak, Krzysztof J.; Toma, Aurel; Hengstenberg, Christian; Siller-Matula, Jolanta M.
• Is Part Of: Platelets. Volume 32:Number 4(2021)
• Page Start: 498
• Page End: 506
• Publication Date: 2021-05-19
• Subjects: Acute Coronary Syndrome -- inflammation -- platelet Reactivity -- prasugrel -- statin -- ticagrelor; Blood platelets -- Periodicals; Blood Platelets -- Periodicals; 615.39
• DOI: 10.1080/09537104.2020.1766670
• Languages: English
• ISSNs: 0953-7104

Abstract

Abstract: Inflammation leads to atherosclerosis and acute coronary syndromes (ACS). We performed a prospective, observational study to assess association between the concentrations of inflammatory markers (high sensitivity C-reactive protein, hsCRP; high sensitivity interleukin6, hsIL-6; soluble CD40 ligand, sCD40 L) and platelet reactivity in 338 patients with ACS treated with ticagrelor and prasugrel. We also assessed whether hsCRP, hsIL-6, and sCD40 L are associated with standard inflammatory markers (white blood cell [WBC] and fibrinogen), and whether they differ according to patient diabetic status and pre-treatment with statins. Concentrations of hsCRP and concentrations of hsIL-6 and sCD40 L were assessed using turbidimetric assay and enzyme-linked immunosorbent assay, respectively. Platelet reactivity was measured using multiple electrode aggregometry. There was only a weak inverse correlation between hsIL-6 and platelet reactivity (r≤-0.125). In contrast, concentration of hsIL6 and hsCRP positively correlated with WBC and fibrinogen (r ≥ 0.199). Insulin-dependent diabetes mellitus (IDDM) was associated with higher concentration of hsIL-6 ( p = .014), whereas pre-treatment with statins – with lower concentration of hsIL-6 ( p = .035). In conclusion, inflammatory state does not affect the antiplatelet efficacy of potent P2Y12 inhibitors in the acute phase of ACS, confirming the safety and efficacy of potent P2Y12 inhibitors in patients with a high inflammatory burden.