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Mean platelet volume and high-residual platelet reactivity in patients receiving dual antiplatelet therapy with clopidogrel or ticagrelor
- Source :
- Expert Opinion on Pharmacotherapy, 16, 12, pp. 1739-47, Expert Opinion on Pharmacotherapy, 16, 1739-47
- Publication Year :
- 2015
-
Abstract
- Item does not contain fulltext OBJECTIVE: High on-treatment platelet reactivity (HRPR) is associated with a two- to ninefold increased risk of recurrent ischemic events among patients receiving dual antiplatelet therapy (DAPT) for coronary artery disease. However, its determinants are still poorly understood. The aim of the present study was to assess the impact of mean platelet volume (MPV) on platelet reactivity in patients receiving DAPT after an acute coronary syndrome or PCI. METHODS: Patients treated with DAPT (acetylsalicylic acid [ASA] and clopidogrel or ticagrelor) were scheduled for platelet function assessment at 30 - 90 days post-discharge. By whole blood impedance aggregometry, HRPR was considered for ASPI test > 862 aggregation units (AU)*min (for ASA) and ADP test values >/= 417 AU*min (for ADP-antagonists). RESULTS: Our population is represented by a total of 487 patients on DAPT, divided according to MPV tertiles (< 10.4 fl; 10.4 - 11.29 fl; >/= 11.3 fl). Larger-sized platelets were associated with use of statins (p < 0.001) and beta-blockers (p = 0.03), higher hemoglobin levels (p = 0.002) and lower platelets count (p < 0.001). Higher platelet reactivity was observed at ASPI test in patients with higher MPV (r = 0.12, p = 0.008), but not for ADP-mediated aggregation (r = -0.007, p = 0.88). However, a low prevalence of HRPR was observed with ASA, with no impact of MPV tertiles (1.2 vs 1.1 vs 1.6%, p = 0.70, adjusted OR [95% CI] = 1.05 [0.51 - 1.77], p = 0.87). MPV did not influence the prevalence of HRPR for ADP-antagonists (25.9 vs 1 vs 26.5%, p = 0.89; adjusted OR [95% CI] = 1.1 [0.84 - 1.45], p = 0.50) with similar results among the 259 patients receiving clopidogrel (adjusted OR [95% CI] = 1.15 [0.82 - 1.62], p = 0.43) and the 228 patients on ticagrelor (adjusted OR [95% CI] = 1.46 [0.84 - 2.55], p = 0.18). CONCLUSION: In patients receiving DAPT, MPV does not affect the response to major antiplatelet therapies. In fact, MPV elevation does not influence the risk of HRPR with clopidogrel, ticagrelor or ASA.
- Subjects :
- Blood Platelets
Male
Acute coronary syndrome
medicine.medical_specialty
Ticagrelor
Adenosine
Ticlopidine
Platelet Aggregation
Platelet Function Tests
Population
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
clopidogrel, coronary artery disease, dual antiplatelet therapy, high-residual platelet reactivity, mean platelet volume, platelet aggregation, platelet volume, ticagrelor
Coronary Artery Disease
Coronary artery disease
Percutaneous Coronary Intervention
Internal medicine
medicine
Humans
Pharmacology (medical)
Platelet
high-residual platelet reactivity
Mean platelet volume
Acute Coronary Syndrome
education
Whole blood
Aged
Pharmacology
education.field_of_study
Aspirin
business.industry
General Medicine
Middle Aged
Clopidogrel
medicine.disease
dual antiplatelet therapy
Anesthesia
Cardiology
platelet volume
Drug Therapy, Combination
Female
business
Mean Platelet Volume
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 17447666 and 14656566
- Volume :
- 16
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Expert opinion on pharmacotherapy
- Accession number :
- edsair.doi.dedup.....3b80633374c5441914954603cedb90e4