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RESEARCH PRODUCT

Impact of Platelet Reactivity in ACS Patients on Clinical Outcomes with Triple Antithrombotic Therapy

Franck PaganelliMaud MazaLaurent BonelloJulia GruttemeierMarianne ZellerEmmanuel De MaistreMarc LaineYves CottinH. YaoNoémie ResseguierLaurence Camoin-jau

subject

platelet reactivityAcute coronary syndromemedicine.medical_specialtyThienopyridinetriple antithrombotic therapymedicine.medical_treatmentlcsh:Medicine030204 cardiovascular system & hematologyLoading doseArticleacute coronary syndromeVASP index03 medical and health sciences0302 clinical medicineInternal medicineAntithromboticClinical endpointMedicinecardiovascular diseases030212 general & internal medicineclopidogrelbusiness.industrylcsh:RPercutaneous coronary interventionGeneral Medicinemedicine.diseaseClopidogrelConventional PCICardiologybusinessmedicine.drug

description

Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients on oral anticoagulants (OAC) remains a clinical conundrum. In fact, combining an OAC with dual antiplatelet therapy (triple antithrombotic therapy, TAT) increases the risk of bleeding. Clopidogrel is the only thienopyridine recommended in TAT patients. Whether its response plays a relevant role in this setting remains uncertain. We aimed to evaluate the level of platelet reactivity inhibition (PRI) achieved by oral TAT in Acute Coronary Syndrome (ACS) patients undergoing PCI and its relationship with outcomes. We performed a multicenter prospective observational study and assessed PRI by vasodilator-stimulated phosphoprotein (VASP) index following a loading dose of clopidogrel. The primary endpoint was the incidence of major adverse cerebral or cardiovascular events (MACCE) at six months based on High on Treatment Platelet Reactivity (HTPR, VASP &gt

yearjournalcountryeditionlanguage
2021-04-01Journal of Clinical Medicine
https://doi.org/10.3390/jcm10081565