Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome

Anna Toso, Stefano De Servi, Mario Leoncini, Dominick J. Angiolillo, Paolo Calabrò, Federico Piscione, Marco Cattaneo, Diego Maffeo, Antonio Bartorelli, Cataldo Palmieri, Marco De Carlo, Davide Capodanno, Philippe Genereux, Francesco Bellandi, Chiara Barozzi, Luciana Tomasi, Diego Della Riva, Tullio Palmerini

Research output: Contribution to journalArticle

Abstract

Statin use is associated with enhanced pharmacodynamic response to clopidogrel in patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). However, the impact of statin therapy on clopidogrel response profiles in patients with acute coronary syndrome (ACS) undergoing PCI has not been established and represents the objective of this investigation. On-treatment P2Y12 platelet reactivity was measured using the vasodilator stimulated phosphoprotein (VASP) phosphorylation assay before PCI, at hospital discharge, and at 1 month after PCI in ACS patients enrolled in the multicenter, prospective GEne polymorphisms, Platelet Reactivity, and Syntax Score (GEPRESS) study (n = 962). High platelet reactivity (HPR) was defined as platelet reactivity index ≥50%. Statins were prescribed at hospital discharge in 87% (n = 835) of patients. All patients were followed for 1 year. The 1-month HPR rate was lower in statin than in non-statin treated patients (39.6 vs 52%, respectively, p = 0.009). This finding was confirmed also among statin-treated patients with high Syntax score (≥15). After adjustment for differences in baseline characteristics, statin use at discharge was independently associated with 1-month HPR rate (odds ratio, 0.58, 95% confidence interval, 0.38–0.89; p = 0.015). In ACS patients undergoing PCI treated with clopidogrel the use of statins at discharge was associated with significantly lower 1-month HPR rates compared with patients not treated with statins.

Original languageEnglish
Pages (from-to)355-361
Number of pages7
JournalJournal of Thrombosis and Thrombolysis
Volume44
Issue number3
DOIs
Publication statusPublished - Oct 1 2017

Keywords

  • Acute coronary syndrome
  • Clopidogrel
  • High platelet reactivity
  • Pharmacodynamics
  • Statins

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome'. Together they form a unique fingerprint.

  • Cite this

    Toso, A., De Servi, S., Leoncini, M., Angiolillo, D. J., Calabrò, P., Piscione, F., Cattaneo, M., Maffeo, D., Bartorelli, A., Palmieri, C., De Carlo, M., Capodanno, D., Genereux, P., Bellandi, F., Barozzi, C., Tomasi, L., Della Riva, D., & Palmerini, T. (2017). Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome. Journal of Thrombosis and Thrombolysis, 44(3), 355-361. https://doi.org/10.1007/s11239-017-1541-x