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Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome

BACKGROUND: Coronary artery disease (CAD) has been recognized as a serious and potentially life‐threatening complication of Hepatitis C Virus (HCV) infection. High on‐treatment platelet reactivity has been associated with high risk of ischemic events in patients with CAD, but data regarding the asso...

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Autores principales: Scudiero, Fernando, Valenti, Renato, Marcucci, Rossella, Sanna, Giuseppe D., Gori, Anna Maria, Migliorini, Angela, Vitale, Raffaele, Giusti, Betti, De Vito, Elena, Corda, Giulia, Paniccia, Rita, Zirolia, Davide, Canonico, Mario E., Parodi, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726996/
https://www.ncbi.nlm.nih.gov/pubmed/32885738
http://dx.doi.org/10.1161/JAHA.120.016441
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author Scudiero, Fernando
Valenti, Renato
Marcucci, Rossella
Sanna, Giuseppe D.
Gori, Anna Maria
Migliorini, Angela
Vitale, Raffaele
Giusti, Betti
De Vito, Elena
Corda, Giulia
Paniccia, Rita
Zirolia, Davide
Canonico, Mario E.
Parodi, Guido
author_facet Scudiero, Fernando
Valenti, Renato
Marcucci, Rossella
Sanna, Giuseppe D.
Gori, Anna Maria
Migliorini, Angela
Vitale, Raffaele
Giusti, Betti
De Vito, Elena
Corda, Giulia
Paniccia, Rita
Zirolia, Davide
Canonico, Mario E.
Parodi, Guido
author_sort Scudiero, Fernando
collection PubMed
description BACKGROUND: Coronary artery disease (CAD) has been recognized as a serious and potentially life‐threatening complication of Hepatitis C Virus (HCV) infection. High on‐treatment platelet reactivity has been associated with high risk of ischemic events in patients with CAD, but data regarding the association with HCV infection are still lacking. This post hoc analysis aims to assess high on‐treatment platelet reactivity, severity of CAD, and long‐term outcomes of patients with acute coronary syndrome (ACS) who were infected with HCV. METHODS AND RESULTS: Patients with ACS who were infected with HCV (n=47) were matched to patients with ACS and without HCV (n=137) for age, sex, diabetes mellitus, hypertension, and renal function. HCV‐infected patients with ACS had higher levels of platelet reactivity (ADP(10)–light transmittance aggregometry, 56±18% versus 44±22% [P=0.002]; arachidonic acid–light transmittance aggregometry, 25±21% versus 16±15% [P=0.011]) and higher rates of high on‐treatment platelet reactivity on clopidogrel and aspirin compared with patients without HCV. Moreover, HCV‐infected patients with ACS had higher rates of multivessel disease (53% versus 30%; P=0.004) and 3‐vessel disease (32% versus 7%; P<0.001) compared with patients without HCV. At long‐term follow‐up, estimated rates of major adverse cardiovascular events (cardiac death, nonfatal myocardial infarction, and ischemia‐driven revascularization) were 57% versus 34% (P=0.005) in HCV‐ and non–HCV‐infected patients with ACS, respectively. In addition, thrombolysis In Myocardial Infarction (TIMI) major bleeding rates were higher in HCV‐infected patients (11% versus 3%; P=0.043) compared with noninfected patients. Multivariable analysis demonstrated that HCV infection was an independent predictor of high on‐treatment platelet reactivity, severity of CAD, and long‐term outcome. CONCLUSIONS: In this hypothesis‐generating study, patients with ACS and HCV infection showed increased on‐treatment platelet reactivity, more severe CAD, and worse prognosis compared with patients without HCV.
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spelling pubmed-77269962020-12-13 Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome Scudiero, Fernando Valenti, Renato Marcucci, Rossella Sanna, Giuseppe D. Gori, Anna Maria Migliorini, Angela Vitale, Raffaele Giusti, Betti De Vito, Elena Corda, Giulia Paniccia, Rita Zirolia, Davide Canonico, Mario E. Parodi, Guido J Am Heart Assoc Original Research BACKGROUND: Coronary artery disease (CAD) has been recognized as a serious and potentially life‐threatening complication of Hepatitis C Virus (HCV) infection. High on‐treatment platelet reactivity has been associated with high risk of ischemic events in patients with CAD, but data regarding the association with HCV infection are still lacking. This post hoc analysis aims to assess high on‐treatment platelet reactivity, severity of CAD, and long‐term outcomes of patients with acute coronary syndrome (ACS) who were infected with HCV. METHODS AND RESULTS: Patients with ACS who were infected with HCV (n=47) were matched to patients with ACS and without HCV (n=137) for age, sex, diabetes mellitus, hypertension, and renal function. HCV‐infected patients with ACS had higher levels of platelet reactivity (ADP(10)–light transmittance aggregometry, 56±18% versus 44±22% [P=0.002]; arachidonic acid–light transmittance aggregometry, 25±21% versus 16±15% [P=0.011]) and higher rates of high on‐treatment platelet reactivity on clopidogrel and aspirin compared with patients without HCV. Moreover, HCV‐infected patients with ACS had higher rates of multivessel disease (53% versus 30%; P=0.004) and 3‐vessel disease (32% versus 7%; P<0.001) compared with patients without HCV. At long‐term follow‐up, estimated rates of major adverse cardiovascular events (cardiac death, nonfatal myocardial infarction, and ischemia‐driven revascularization) were 57% versus 34% (P=0.005) in HCV‐ and non–HCV‐infected patients with ACS, respectively. In addition, thrombolysis In Myocardial Infarction (TIMI) major bleeding rates were higher in HCV‐infected patients (11% versus 3%; P=0.043) compared with noninfected patients. Multivariable analysis demonstrated that HCV infection was an independent predictor of high on‐treatment platelet reactivity, severity of CAD, and long‐term outcome. CONCLUSIONS: In this hypothesis‐generating study, patients with ACS and HCV infection showed increased on‐treatment platelet reactivity, more severe CAD, and worse prognosis compared with patients without HCV. John Wiley and Sons Inc. 2020-09-04 /pmc/articles/PMC7726996/ /pubmed/32885738 http://dx.doi.org/10.1161/JAHA.120.016441 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Scudiero, Fernando
Valenti, Renato
Marcucci, Rossella
Sanna, Giuseppe D.
Gori, Anna Maria
Migliorini, Angela
Vitale, Raffaele
Giusti, Betti
De Vito, Elena
Corda, Giulia
Paniccia, Rita
Zirolia, Davide
Canonico, Mario E.
Parodi, Guido
Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome
title Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome
title_full Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome
title_fullStr Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome
title_full_unstemmed Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome
title_short Platelet Reactivity in Hepatitis C Virus–Infected Patients on Dual Antiplatelet Therapy for Acute Coronary Syndrome
title_sort platelet reactivity in hepatitis c virus–infected patients on dual antiplatelet therapy for acute coronary syndrome
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726996/
https://www.ncbi.nlm.nih.gov/pubmed/32885738
http://dx.doi.org/10.1161/JAHA.120.016441
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