August 23, 2013Platelets
Thresholds for platelet reactivity to predict clinical events after coronary intervention are different in patients with and without diabetes mellitus
Key result
High platelet reactivity based on specific thresholds (>256 PRU in diabetics, >229 PRU in non-diabetics) was a strong independent predictor of 30-day MACE (OR 4.80; 95% CI 2.58-8.93; p<0.001).
Why the study?
Do diabetes-specific thresholds for high platelet reactivity better predict 30-day MACE in patients undergoing elective PCI on aspirin and clopidogrel?
Population
640 consecutive patients taking aspirin and clopidogrel undergoing elective PCI, including 32.6% with…
Comparison
High platelet reactivity defined by… vs Patients without high platelet reactivity based…
Design
Cohort
Follow-up
30-day
Authors
Discussion
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Implication
Diabetes-specific PRU thresholds may refine 30-day MACE risk stratification after elective PCI; hypothesis-generating and requires prospective validation.
Study Design
Type
Observational (n=640)
Structured PICO
Do diabetes-specific thresholds for high platelet reactivity better predict 30-day MACE in patients undergoing elective PCI on aspirin and clopidogrel?
P
Population
640 consecutive patients taking aspirin and clopidogrel undergoing elective PCI (32.6% with diabetes mellitus), evaluated for 30-day clinical outcomes.
E
Exposure
High platelet reactivity defined by diabetes-specific thresholds (PRU >256 in diabetics, PRU >229 in non-diabetics) using the VerifyNow P2Y12 assay
C
Comparator
Patients without high platelet reactivity based on these specific thresholds
O
Outcome
30-day incidence of major adverse cardiac events (MACE)composite
Main Result
Odds Ratio: 4.8 (95% CI 2.58–8.93)
p-value: p=< 0.001
Using diabetes-specific thresholds for high platelet reactivity (PRU >256 for diabetics, >229 for non-diabetics) improves the prediction of 30-day MACE after elective PCI.
Cite This Study
Mangiacapra et al. (2013) conducted an observational in Patients undergoing elective percutaneous coronary intervention (n=640). High platelet reactivity based on specific thresholds (HPR-ST) vs. Normal platelet reactivity was evaluated on 30-day incidence of major adverse cardiac events (MACE) (OR 4.80, 95% CI 2.58-8.93, p=< 0.001). High platelet reactivity based on specific thresholds (>256 PRU in diabetics, >229 PRU in non-diabetics) was a strong independent predictor of 30-day MACE (OR 4.80; 95% CI 2.58-8.93; p<0.001).