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Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention

Platelet function testing (PFT) could be a useful clinical tool to guide individualized antithrombotic treatment in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). We aimed to investigate platelet reactivity (PR) in the context of a contemporary registry....

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Autores principales: Lianos, Ioannis, Varlamos, Charalampos, Benetou, Despoina-Rafailia, Mantis, Christos, Kintis, Konstantinos, Dragona, Vassiliki-Maria, Kanakakis, Ioannis, Sionis, Dimitrios, Patsilinakos, Sotirios, Alexopoulos, Dimitrios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925488/
https://www.ncbi.nlm.nih.gov/pubmed/36369420
http://dx.doi.org/10.1007/s11239-022-02723-4
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author Lianos, Ioannis
Varlamos, Charalampos
Benetou, Despoina-Rafailia
Mantis, Christos
Kintis, Konstantinos
Dragona, Vassiliki-Maria
Kanakakis, Ioannis
Sionis, Dimitrios
Patsilinakos, Sotirios
Alexopoulos, Dimitrios
author_facet Lianos, Ioannis
Varlamos, Charalampos
Benetou, Despoina-Rafailia
Mantis, Christos
Kintis, Konstantinos
Dragona, Vassiliki-Maria
Kanakakis, Ioannis
Sionis, Dimitrios
Patsilinakos, Sotirios
Alexopoulos, Dimitrios
author_sort Lianos, Ioannis
collection PubMed
description Platelet function testing (PFT) could be a useful clinical tool to guide individualized antithrombotic treatment in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). We aimed to investigate platelet reactivity (PR) in the context of a contemporary registry. “Real-world” data were retrieved from a nationwide, multicenter, observational study of AF patients on oral anticoagulants (OAC) undergoing PCI. Patients treated with a P2Y(12) inhibitor, namely clopidogrel or ticagrelor, as part of double or triple antithrombotic therapy, were submitted to PFT before discharge and were followed up for 12 months. Out of 101 patients included in the study, 66 were submitted to PFT while on clopidogrel and 35 while on ticagrelor; PR was 162.9 ± 68 PRU and 46.02 ± 46 PRU, respectively (P < 0.001). High on-treatment PR (HTPR) was observed in 15 patients under clopidogrel (22.7%); 7 of them escalated to ticagrelor. Low on-treatment PR (LTPR) was found in 9 clopidogrel and 28 ticagrelor-treated patients (13.6% vs. 80%, P < 0.001), of whom only 1 de-escalated to clopidogrel. PR did not differ by OAC regimen. PFT results had no impact on aspirin prescription at discharge, while failed to predict significant bleeding events at follow up. Ticagrelor administration led to lower PR and lower incidence of HTPR in comparison with clopidogrel. Physicians’ behavior in response to knowledge of a patient’s PR was variable. Further studies are required to elucidate the role of PFT as a tool to guide individualized antithrombotic treatment in this clinical scenario. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11239-022-02723-4.
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spelling pubmed-99254882023-02-15 Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention Lianos, Ioannis Varlamos, Charalampos Benetou, Despoina-Rafailia Mantis, Christos Kintis, Konstantinos Dragona, Vassiliki-Maria Kanakakis, Ioannis Sionis, Dimitrios Patsilinakos, Sotirios Alexopoulos, Dimitrios J Thromb Thrombolysis Article Platelet function testing (PFT) could be a useful clinical tool to guide individualized antithrombotic treatment in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). We aimed to investigate platelet reactivity (PR) in the context of a contemporary registry. “Real-world” data were retrieved from a nationwide, multicenter, observational study of AF patients on oral anticoagulants (OAC) undergoing PCI. Patients treated with a P2Y(12) inhibitor, namely clopidogrel or ticagrelor, as part of double or triple antithrombotic therapy, were submitted to PFT before discharge and were followed up for 12 months. Out of 101 patients included in the study, 66 were submitted to PFT while on clopidogrel and 35 while on ticagrelor; PR was 162.9 ± 68 PRU and 46.02 ± 46 PRU, respectively (P < 0.001). High on-treatment PR (HTPR) was observed in 15 patients under clopidogrel (22.7%); 7 of them escalated to ticagrelor. Low on-treatment PR (LTPR) was found in 9 clopidogrel and 28 ticagrelor-treated patients (13.6% vs. 80%, P < 0.001), of whom only 1 de-escalated to clopidogrel. PR did not differ by OAC regimen. PFT results had no impact on aspirin prescription at discharge, while failed to predict significant bleeding events at follow up. Ticagrelor administration led to lower PR and lower incidence of HTPR in comparison with clopidogrel. Physicians’ behavior in response to knowledge of a patient’s PR was variable. Further studies are required to elucidate the role of PFT as a tool to guide individualized antithrombotic treatment in this clinical scenario. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11239-022-02723-4. Springer US 2022-11-12 2023 /pmc/articles/PMC9925488/ /pubmed/36369420 http://dx.doi.org/10.1007/s11239-022-02723-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Lianos, Ioannis
Varlamos, Charalampos
Benetou, Despoina-Rafailia
Mantis, Christos
Kintis, Konstantinos
Dragona, Vassiliki-Maria
Kanakakis, Ioannis
Sionis, Dimitrios
Patsilinakos, Sotirios
Alexopoulos, Dimitrios
Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
title Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
title_full Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
title_fullStr Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
title_full_unstemmed Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
title_short Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
title_sort platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925488/
https://www.ncbi.nlm.nih.gov/pubmed/36369420
http://dx.doi.org/10.1007/s11239-022-02723-4
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