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Platelet Turnover Predicts Outcome after Coronary Intervention

Elevated platelet turnover contributes to high platelet reactivity. High platelet reactivity after percutaneous coronary intervention (PCI) is associated with major adverse cardiovascular events (MACE). The purpose of this study was to determine the prognostic value of platelet turnover and function...

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Autores principales: Freynhofer, Matthias K., Iliev, Liana, Bruno, Veronika, Rohla, Miklos, Egger, Florian, Weiss, Thomas W., Hübl, Wolfgang, Willheim, Martin, Wojta, Johann, Huber, Kurt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Schattauer 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442606/
https://www.ncbi.nlm.nih.gov/pubmed/28229159
http://dx.doi.org/10.1160/TH16-10-0785
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author Freynhofer, Matthias K.
Iliev, Liana
Bruno, Veronika
Rohla, Miklos
Egger, Florian
Weiss, Thomas W.
Hübl, Wolfgang
Willheim, Martin
Wojta, Johann
Huber, Kurt
author_facet Freynhofer, Matthias K.
Iliev, Liana
Bruno, Veronika
Rohla, Miklos
Egger, Florian
Weiss, Thomas W.
Hübl, Wolfgang
Willheim, Martin
Wojta, Johann
Huber, Kurt
author_sort Freynhofer, Matthias K.
collection PubMed
description Elevated platelet turnover contributes to high platelet reactivity. High platelet reactivity after percutaneous coronary intervention (PCI) is associated with major adverse cardiovascular events (MACE). The purpose of this study was to determine the prognostic value of platelet turnover and function with regard to MACE after PCI with stent implantation. In this prospective observational study, 486 consecutive patients after PCI on aspirin and clopidogrel were included to determine platelet turnover (mean platelet volume (MPV), reticulated platelet fraction (RPF)) and platelet function (multiple electrode aggregometry (MEA), vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P) assay). At six-months follow-up, MACE occurred in 10.7 % of patients. RPF (odds ratio [OR]=1.173 (95% confidence interval [CI 95 %] 1.040–1.324), p=0.009) and MPV (OR=1.459 (CI 95 % 1.059–2.008), p=0.021) were univariable predictors of MACE, whereas VASP-P (OR=1.016 (CI 95 % 1.000–1.032), p=0.052) and MEA (OR=0.999 (CI 95 % 0.980–1.017), p=0.895) failed to predict MACE. RPF remained the only platelet variable independently associated with MACE. The best model to predict MACE included: troponin I (OR=1.007 (CI 95 % 1.002–1.012), p=0.009), RPF (OR=1.136 (CI 95 % 1.001–1.288), p=0.048), CRP (OR=1.008 (CI 95 % 1.001–1.014), p=0.023) and history of myocardial infarction (OR=2.039 (CI 95 % 1.093–3.806), p=0.025). RPF (OR=1.211 (CI 95 % 1.042–1.406), p=0.012) was also independently associated with in-hospital bleedings. In conclusion, RPF as index of platelet turnover is an independent predictor of MACE and bleeding events in PCI patients on dual antiplatelet therapy. Since RPF can reliably be quantified along with routine haemograms, RPF might easily be applied in the setting of cardiovascular risk prediction.
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spelling pubmed-54426062017-06-02 Platelet Turnover Predicts Outcome after Coronary Intervention Freynhofer, Matthias K. Iliev, Liana Bruno, Veronika Rohla, Miklos Egger, Florian Weiss, Thomas W. Hübl, Wolfgang Willheim, Martin Wojta, Johann Huber, Kurt Thromb Haemost Coagulation and Fibrinolysis Elevated platelet turnover contributes to high platelet reactivity. High platelet reactivity after percutaneous coronary intervention (PCI) is associated with major adverse cardiovascular events (MACE). The purpose of this study was to determine the prognostic value of platelet turnover and function with regard to MACE after PCI with stent implantation. In this prospective observational study, 486 consecutive patients after PCI on aspirin and clopidogrel were included to determine platelet turnover (mean platelet volume (MPV), reticulated platelet fraction (RPF)) and platelet function (multiple electrode aggregometry (MEA), vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P) assay). At six-months follow-up, MACE occurred in 10.7 % of patients. RPF (odds ratio [OR]=1.173 (95% confidence interval [CI 95 %] 1.040–1.324), p=0.009) and MPV (OR=1.459 (CI 95 % 1.059–2.008), p=0.021) were univariable predictors of MACE, whereas VASP-P (OR=1.016 (CI 95 % 1.000–1.032), p=0.052) and MEA (OR=0.999 (CI 95 % 0.980–1.017), p=0.895) failed to predict MACE. RPF remained the only platelet variable independently associated with MACE. The best model to predict MACE included: troponin I (OR=1.007 (CI 95 % 1.002–1.012), p=0.009), RPF (OR=1.136 (CI 95 % 1.001–1.288), p=0.048), CRP (OR=1.008 (CI 95 % 1.001–1.014), p=0.023) and history of myocardial infarction (OR=2.039 (CI 95 % 1.093–3.806), p=0.025). RPF (OR=1.211 (CI 95 % 1.042–1.406), p=0.012) was also independently associated with in-hospital bleedings. In conclusion, RPF as index of platelet turnover is an independent predictor of MACE and bleeding events in PCI patients on dual antiplatelet therapy. Since RPF can reliably be quantified along with routine haemograms, RPF might easily be applied in the setting of cardiovascular risk prediction. Schattauer 2017-02-23 2017-05-08 /pmc/articles/PMC5442606/ /pubmed/28229159 http://dx.doi.org/10.1160/TH16-10-0785 Text en © Copyright Schattauer 2017 https://creativecommons.org/licenses/by/4.0/ License terms: CC-BY (https://creativecommons.org/licenses/by/4.0)
spellingShingle Coagulation and Fibrinolysis
Freynhofer, Matthias K.
Iliev, Liana
Bruno, Veronika
Rohla, Miklos
Egger, Florian
Weiss, Thomas W.
Hübl, Wolfgang
Willheim, Martin
Wojta, Johann
Huber, Kurt
Platelet Turnover Predicts Outcome after Coronary Intervention
title Platelet Turnover Predicts Outcome after Coronary Intervention
title_full Platelet Turnover Predicts Outcome after Coronary Intervention
title_fullStr Platelet Turnover Predicts Outcome after Coronary Intervention
title_full_unstemmed Platelet Turnover Predicts Outcome after Coronary Intervention
title_short Platelet Turnover Predicts Outcome after Coronary Intervention
title_sort platelet turnover predicts outcome after coronary intervention
topic Coagulation and Fibrinolysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442606/
https://www.ncbi.nlm.nih.gov/pubmed/28229159
http://dx.doi.org/10.1160/TH16-10-0785
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