1. Influence of smoking on the antiplatelet effect of clopidogrel differs according to clopidogrel dose: Insights from the GRAVITAS trial
- Author
-
Christopher P. Cannon, Paul S. Teirstein, Dominick J. Angiolillo, Matthew J. Price, Jean-François Tanguay, Grant W. Reed, Peter B. Berger, and Jill Waalen
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Platelet reactivity ,03 medical and health sciences ,0302 clinical medicine ,P2Y12 ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,030212 general & internal medicine ,business.industry ,Percutaneous coronary intervention ,General Medicine ,Odds ratio ,medicine.disease ,Clopidogrel ,Thrombosis ,Confidence interval ,Anesthesia ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Objective To examine the influence of smoking on the antiplatelet effect of clopidogrel following percutaneous coronary intervention (PCI). Background Certain studies suggest smokers may have enhanced clopidogrel-induced platelet inhibition compared to non-smokers after PCI. Whether this is affected by clopidogrel dose is unknown. Methods In this study, we conducted an analysis of 5,429 patients in the Gauging Responsiveness With A VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial. Platelet reactivity was assessed 12–24 hr after PCI (baseline). Patients with high on-treatment platelet reactivity (OTR) (P2Y12 reaction units [PRU] ≥ 230) were randomized to clopidogrel 75 mg or 150 mg daily. Reactivity was subsequently assessed at 30-days, and 6-months. Patients were stratified by smoking status. Results Smoking was independently associated with lower PRU (P = 0.001), and smokers were less likely to have high OTR (odds ratio 0.80, 95% confidence interval 0.68–0.94; P = 0.006) at baseline. Among patients assigned to clopidogrel 75 mg, smokers had lower PRU and were less likely to still have high OTR at 30-days (P
- Published
- 2016
- Full Text
- View/download PDF