High on-aspirin platelet reactivity predicts cardiac death in acute coronary syndrome patients undergoing PCI

Anna Maria Gori, Elisa Grifoni, Renato Valenti, Betti Giusti, Rita Paniccia, Guido Parodi, Angela Migliorini, David Antoniucci, Rosanna Abbate, Gian Franco Gensini, Rossella Marcucci

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the possible role of high on-aspirin platelet reactivity (HaPR) in a prospective cohort of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Background: Several studies documented that high on-clopidogrel platelet reactivity (HcPR) is associated with increased risk of ischemic events in ACS patients undergoing PCI. On the contrary, conflicting data are available on HaPR and clinical outcome. Methods: Platelet reactivity was assessed by light transmittance aggregometry using arachidonic acid as an agonist in 1789 ACS patients undergoing PCI. Results: HaPR was found in 20.3% of patients. These patients were significantly older, with a higher prevalence of hypertension, diabetes and reduced ejection fraction. Patients with non ST-segment elevation ACS, 3-vessel disease and multivessel PCI had a significantly higher prevalence of HaPR. In addition, stent number and length, and use of drug-eluting stents were significantly higher in HaPR patients. At 24-month follow-up the prevalence of cardiac death was 9.7% in HaPR and 3.8% in non-HaPR [HR2.63(1.72-4.02), p

Original languageEnglish
JournalEuropean Journal of Internal Medicine
DOIs
Publication statusAccepted/In press - Oct 5 2015

Keywords

  • Acute coronary syndrome
  • Aspirin resistance
  • High on-treatment platelet reactivity
  • Platelet reactivity

ASJC Scopus subject areas

  • Internal Medicine

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