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Impact of Long-Term Dual Antiplatelet Therapy on Immature Platelet Count and Platelet Reactivity
- Source :
- Angiology, 69, 490-496, Angiology, 69, 6, pp. 490-496
- Publication Year :
- 2018
-
Abstract
- The immature platelet count (IPC) is a potential marker of platelet reactivity. We assessed the relationship between IPC during chronic dual antiplatelet therapy (DAPT) and the response to antiplatelet drugs (acetylsalycilic acid + clopidogrel/ticagrelor). We included 286 patients: 167 (58.4%) patients received ticagrelor and 119 (41.6%) received clopidogrel. At a median follow-up of 46.5 days, the variation in IPC displayed an absolute median (interquartile range [IQR]) of −11.9 × 103/µL (−182.7 to 160.8), corresponding to a median percentage change in IPC ([%ΔIPC] IQR) of −0.3% (−21.9% to 35.5%), with an increase in IPC levels in those on ticagrelor and a decrease in IPC levels in those on clopidogrel. We observed an inverse association of lower platelet reactivity at different tests and a higher increase in IPC ( r = −0.14, P = .04 for arachidonic acid test; r = −0.12, P = .05 for collagen test; and r = −0.13, P = .02 for adenosine diphosphate test [ADP]). The rate of poor effectiveness of ADP antagonists was the only independent predictor of a ΔIPC above the third tertile (odds ratio [95% confidence interval] = 0.55 [0.32-0.99]; P = .048). We showed that in patients treated with chronic DAPT, an increase in IPC is significantly related to lower levels of platelet reactivity.
- Subjects :
- Male
Ticagrelor
medicine.medical_specialty
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Coronary Artery Disease
030204 cardiovascular system & hematology
Immature Platelet
Gastroenterology
Drug Administration Schedule
Platelet reactivity
03 medical and health sciences
chemistry.chemical_compound
Percutaneous Coronary Intervention
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Interquartile range
Internal medicine
parasitic diseases
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Acute Coronary Syndrome
Aged
Aspirin
Platelet Count
business.industry
Middle Aged
Platelet Activation
Clopidogrel
Adenosine diphosphate
chemistry
Drug Therapy, Combination
Female
Arachidonic acid
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 00033197
- Volume :
- 69
- Database :
- OpenAIRE
- Journal :
- Angiology
- Accession number :
- edsair.doi.dedup.....d0dd83af14afaae91d95e5df8d3ebb23