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KMID : 0368120120420060382
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Korean Circulation Journal
2012 Volume.42 No. 6 p.382 ~ p.389
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Impact of Platelet Function Test on Platelet Responsiveness and Clinical Outcome After Coronary Stent Implantation: Platelet Responsiveness and Clinical Outcome
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Yu Long-Hao
Kim Moo-Hyun
Zhang Hong-Zhe
Park Jong-Seong
Park Tae-Ho
Kim Young-Dae
Cha Kwang-Soo
Han Jin-Yeong
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Abstract
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Background and Objectives : The aim of this study was to confirm the predictive cut-off values for P2Y12 reaction units (PRU) and aspirin reaction units (ARU) and to evaluate the clinical impact of VerifyNow® assays.
Subjects and Methods : From November 2007 to October 2009, 186 eligible patients were prospectively recruited. Post-treatment platelet reactivity was measured by VerifyNow® assays within 12 to 24 hours after intervention, followed by standard dual maintenance dose therapy for 1 year. All patients had scheduled clinical follow-ups at 1, 3, 6, and 12 months.
Results: The rate of low responders to clopidogrel, aspirin, and both drugs were 41.4%, 10.2%, and 3.8%, respectively. The predictive factors for low responsiveness to clopidogrel (PRU ≥240) were female sex, age, and non-use of cilostazol medication in our univariate analysis and age ≥65 years and non-use cilostazol in the multivariate analysis. The predictors of low responsiveness to aspirin (ARU ≥550) were male sex and age in both univariate and multivariate analyses. There was no significant difference in the clinical event rate with a cut-off value of PRU ≥240 or ARU ≥550 for 30 days and 1-year (p>0.05).
Conclusion: Hyporesponsiveness to antiplatelet agents (namely aspirin and clopidogrel) was identified in about half of the patients. The cut-off point of PRU ≥240 or ARU ≥550 did not confer predictive value for 30-day or 1-year clinical event rates in patients who had undergone coronary intervention with drug-eluting stents.
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KEYWORD
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Platelet function tests, Coronary artery disease, Drug-eluting stents
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