Why the study?
Aging is associated with altered platelet reactivity without antiplatelet therapy, but platelet response to agonist stimulation in elderly patients on potent P2Y12 inhibitors required investigation.
Do elderly patients (≥70 years) on potent P2Y12 inhibitors exhibit different platelet aggregation responses compared to younger patients?
Do elderly patients (≥70 years) on potent P2Y12 inhibitors exhibit different platelet aggregation responses compared to younger patients?
Elderly patients (≥70 years) on potent P2Y12 inhibitors show increased platelet inhibition compared to younger patients, suggesting a potential mechanism for higher bleeding risk in this population.
May explain higher bleeding rates in elderly on potent P2Y12 inhibitors; hypothesis-generating for age-specific dosing trials.
Background: Aging has recently been associated with increased basal platelet activation and platelet hyperreactivity in response to adenosine diphosphate (ADP) but with decreased platelet response to thrombin receptor stimulation in individuals without antiplatelet therapy. Objectives: To investigate platelet response to agonist stimulation in elderly patients (≥70 years) on dual antiplatelet therapy with potent P2Y12 inhibitors. Methods: Platelet aggregation in response to arachidonic acid (AA), ADP, collagen, the protease-activated receptor-1 agonist SFLLRN, and the protease-activated receptor-4 agonist AYPGKF was assessed by multiple electrode aggregometry in 79 prasugrel- and 77 ticagrelor-treated patients 3 days after acute percutaneous coronary intervention. Conclusion: Patients aged ≥70 years on potent P2Y12 inhibitors exhibit increased inhibition of ADP-inducible platelet aggregation. In addition, elderly patients on prasugrel show a lower response to AA, collagen, SFLLRN and AYPGKF than younger patients.
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Mutschlechner et al. (2025) studied this question.
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