August 23, 2019KardiologiiaOpen Access

Clinical and prognostic value of the residual activity of platelets in patients with acute coronary syndrome without st segment elevation

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Why the study?

The clinical and prognostic value of residual platelet activity in patients with non-ST-elevation acute coronary syndrome remained to be investigated.

Does high residual platelet reactivity increase the risk of ischemic events in patients with NSTE ACS undergoing coronary stenting?

Population

120 NSTE ACS patients undergoing coronary artery stenting

Comparison

Low residual platelet reactivity vs high residual platelet reactivity

Design

Cohort study

Follow-up

16 ± 6 months

Authors

OSO. A. StoykoTyumen Regional Oncological Dispensary СШС. В. ШалаевClinical Hospital No. 8

Discussion

Member takes

Implication

High residual platelet reactivity may flag higher ischemic risk post-NSTE-ACS stenting; leaves open whether testing should guide therapy.

Structured PICO

Does high residual platelet reactivity increase the risk of ischemic events in patients with NSTE ACS undergoing coronary stenting?

Population

120 patients with acute coronary syndrome without ST segment elevation (NSTE ACS) undergoing coronary artery stenting, mean age 62, 75% male, from a single center in Russia.

Intervention

High residual reactivity of platelets (HRR, ≥6 Ohm by impedance aggregometry) after loading doses of aspirin and P2Y12-inhibitor (clopidogrel or ticagrelor)

Comparator

Low residual reactivity of platelets (LRR, 0-5 Ohm by impedance aggregometry) after loading doses of aspirin and P2Y12-inhibitor

Outcome

Combined endpoint of cardiovascular death, hospitalization for acute coronary syndrome (myocardial infarction and unstable angina), and ischemic stroke during follow-up (16 ± 6 months)composite

In patients with NSTE-ACS undergoing PCI, high residual platelet reactivity on DAPT is associated with increased ischemic events, whereas very low reactivity is associated with increased bleeding risk.

Limitations

Open-label single-center prospective design
Selection bias (only included patients with PCI during index hospitalization)
Lack of randomization for P2Y12-inhibitor type
Loss to follow-up (3 patients)

Cite This Study

Stoyko et al. (2019) studied this question.

synapsesocial.com/papers/6a73a23c9d09e2fbac279dc7 https://doi.org/10.18087/cardio.2608

Topics

Dual antiplatelet therapy

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Clinical and prognostic value of the residual activity of platelets in patients with acute coronary syndrome without st segment elevation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Clinical and prognostic value of the residual activity of platelets in patients with acute coronary syndrome without st segment elevation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider