High platelet reactivity strongly predicts early stent thrombosis in patients with drug-eluting stent implantation

Author:

Lim Subin,Hong Soon Jun,Kim Ju Hyeon,Cha Jung-Joon,Joo Hyung Joon,Park Jae Hyoung,Yu Cheol Woong,Kim Byeong-Keuk,Chang Kiyuk,Park Yongwhi,Song Young Bin,Ahn Sung Gyun,Suh Jung-Won,Lee Sang Yeub,Cho Jung Rae,Her Ae-Young,Jeong Young-Hoon,Kim Hyo-Soo,Kim Moo Hyun,Shin Eun-Seok,Lim Do-Sun,Kim Hyun Kuk,Lee Jung Hee,Lee Byoung Kwon,Kim Weon,Park Kyung Woo,Moon Jae Yeon,Kwon Osung,Kim Chan Joon,Park Hyun-Woong,Lee Chang Hoon,Jang Woo Jin,Jin Han-Young,Chon Min Ku,Choi Ki Hong,Han Dong Hoon,Kang Min Gyu,Kang Jeehoon,Ki You Jeong,Park Jin Sup,Lee Seung-Jun,Lee Seung Hun,Lee Jong-Young,Cho Sung Won,Suh Jon,Bae Jang-Whan,You Seng Chan,Lim Do-Sun,Jeong Myung Ho,

Abstract

AbstractStent thrombosis (ST) is a fatal complication after percutaneous coronary intervention (PCI). The association between P2Y12 reaction unit (PRU) level and stent thrombosis occurrence remains unclear. Based on the multicenter, observational PTRG-DES (Platelet function and genoType-Related long-term proGnosis in DES-treated patients) registry of patients with drug-eluting stents (DES) implantation, a total of 11,714 patients with PRU values were analyzed. We sought to identify the predictors of early stent thrombosis (EST) and compared the primary outcome, a composite of cardiac death, myocardial infarction, and revascularization, between EST and non-EST groups. EST, defined as definite ST within 1 month after index PCI, occurred in 51 patients. PRU values were significantly higher in the EST group (263.5 ± 70.8 vs. 217.5 ± 78.7, p < 0.001). In multivariable analysis, PRU ≥ 252 (OR, 5.10; 95% CI 1.58–16.46; p = 0.006) and aspirin reaction unit ≥ 414 (OR 4.85; 95% CI 1.07–21.97; p = 0.040) were independent predictors of EST. The cumulative incidence of primary composite outcome at one year was significantly higher in the EST group (38.2% vs. 3.9%, Log-rank p < 0.001). In patients treated with clopidogrel after successful DES implantation, EST was associated with higher platelet reactivities, and a greater risk of cardiovascular events.Trial Registration: clinicaltrials.gov Identifier: NCT04734028.

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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