Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study

Figures

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  Figure 1. Platelet reactivity and cardiovascular and all-cause mortality in the LURIC study. Association between ADP-induced CD63 expression and cardiovascular and all-cause mortality in 1520 patients. ADP-induced CD63-expression was modeled with restricted cubic splines for the hazard of cardiovascular (A) and all-cause mortality (B). Dark line represents the hazard function while the shaded area denotes the 95% confidence interval. All models presented were adjusted for age, sex, living conditions (marital status), alcohol intake, smoking status, anti-platelet therapy, lg-GFR, lg-CRP, lg-systolic lg-bloodpressure, Charlson Comorbidity Index and Friesinger Score (model 4). (C,D) Crude and stepwise risk-factor adjusted hazard ratios of cardiovascular (C) and all-cause mortality (D) according to Low- and High-platelet reactivity.

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  Figure 2. High- and Low-platelet reactivity is risk-equivalent to coronary artery disease. Kaplan-Meier cumulative event curves in 1520 patients for cardiovascular (A) and all-cause mortality (B) in patients stratified by the presence (i.e., at least ≥1 angiographically verified stenosis of ≥20%) and absence of coronary artery disease and High/Low platelet reactivity.

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  Figure 3. Relative Importance of risk factors that predict cardiovascular and all-cause mortality. Relative Importance analysis for 464 patients in the Low platelet reactivity group, 545 in the Reference group, and 511 in the High platelet reactivity group. The estimated relative importance denotes the strength of the association (R2) for risk-factor variables for predicting cardiovascular (A) and all-cause mortality (B) among patients with High- and Low-platelet reactivity and the Reference group. The Cox model applied for this relative weight analysis is similar to model 4 in Figure 1. BMI—body mass index, eGFR—glomerular filtration rate, LDL-C—Low-density Lipoprotein, hsCRP—high-sensitive C-reactive Protein, CCI—Charlson Comorbidity Index; Blue circle—Low platelet reactivity; Green circle—Reference Group; Red circle—High platelet reactivity.

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  Figure 4. Risk factor-stratified hazard ratios for cardiovascular and all-cause mortality among patients with altered platelet reactivity and the reference group. Forest plot for cardiovascular (A) and all-cause mortality (B) based on key risk factors/therapies identified by relative weight analysis. Patients with High-(red dot, 511 patients) and Low-(blue dot, 464 patients) platelet reactivity were stratified according to the presence or absence of the appropriate factor. Risk was compared to the risk of the Reference group (545 patients). Continuous variables were a priori categorized based on available guidelines or previous studies (i.e., hs-CRP). The cardiovascular mortality risk in each group was compared to the reference group in the absence of the factor of interest/presence of the therapy of interest. Models were adjusted for age and sex similar to model 1 in Figure 1.