Key result
Higher ADP-induced whole blood platelet aggregation rates were independently associated with an increased risk of composite ischemic events and death.
Why the study?
Data were very limited regarding the prediction of ischemic events using platelet function tests via dynamic platelet aggregation counting in patients with coronary heart disease on clopidogrel.
Does ADP-induced whole blood platelet aggregation rate via DPAC predict ischemic events and all-cause death in patients with coronary heart disease treated with clopidogrel?
Cohort (n=490)
Does ADP-induced whole blood platelet aggregation rate via DPAC predict ischemic events and all-cause death in patients with coronary heart disease treated with clopidogrel?
ADP-induced whole blood platelet aggregation rates via dynamic platelet aggregation counting can predict 1-year composite ischemic and mortality events in CHD patients on clopidogrel.
Answers are grounded in this paper and cite their sources.
Should not yet guide antiplatelet therapy; leaves open prognostic role of aggregation testing in prospective studies.
In the setting of coronary heart diseases (CHDs) on treatment with clopidogrel, ADP-induced platelet aggregation has been demonstrated with ischemic events. However, there were very limited data for predicting ischemic events by platelet function test via dynamic platelet aggregation counting (DPAC). The present study aimed to evaluate the relationship between adenosine diphosphate (ADP)-induced whole blood platelet aggregation rates (PARs) and clinical outcomes in patients with CHDs on treatment with clopidogrel. We have retrospectively analyzed the clinical data of consecutive patients with CHDs based on the electronic medical records between May 2016 and December 2018. The primary endpoint was a composite endpoint events (CEEs) of ischemic cardiovascular events (including acute coronary syndrome, heart failure, transient ischemic attack, and cerebral infarction) and all-cause death. A total of 490 patients (mean age 66.6 years, 71% man) were received ADP-induced PARs via DPAC. On follow-up (mean 374 days), 107 subjects (21.8%) developed CEEs. Cox regression analysis indicated that the risk of CEEs was independently associated with ADP-induced whole blood PARs [HR: 1.023, 95% CI: 1.005–1.041, P = .011]. The distribution of CYP2C19 loss of function gene was higher in patients with on-treatment platelet hyperresponsiveness (10/12 vs 38/75, P = .042). In conclusion, ADP-induced whole blood PARs via DPAC is feasible, which can predict the incidence of 1-year CEEs in patients with CHDs on treatment with clopidogrel. CYP2C19 gene polymorphism was associated with clopidogrel on-treatment platelet hyperresponsiveness.
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Wan et al. (2020) conducted a cohort in Coronary heart diseases (CHDs) on treatment with clopidogrel (n=490). ADP-induced whole blood platelet aggregation rates (PARs) was evaluated on Composite endpoint events (CEEs) of ischemic cardiovascular events (including acute coronary syndrome, heart failure, transient ischemic attack, and cerebral infarction) and all-cause death (HR 1.023, 95% CI 1.005-1.041, p=0.011). Higher ADP-induced whole blood platelet aggregation rates were independently associated with an increased risk of composite ischemic events and death.
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