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Relationship between diabetes, platelet reactivity, and the SYNTAX score to one-year clinical outcome in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention.
- Source :
-
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2016 Jun 20; Vol. 12 (3), pp. 312-8. - Publication Year :
- 2016
-
Abstract
- Aims: In patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) treated with PCI, high (H) platelet reactivity (PR) significantly affects one-year outcome. The aim of this report was to analyse the relationships between HPR, the SYNTAX score (SS) and one-year major adverse cardiac events (MACE: cardiac death, myocardial infarction, stent thrombosis) according to diabetes mellitus (DM) status in patients included in the GEne Polymorphism, Platelet REactivity, and the Syntax Score (GEPRESS) study.<br />Methods and Results: PR was measured using the vasodilator-stimulated phosphoprotein (VASP) assay at three time points (before PCI, at hospital discharge and at one month after PCI), with HPR defined as >50% PR index in 1,042 patients treated with aspirin and clopidogrel for one year after PCI. Patients with DM and an SS ≥15 had the highest MACE rate between one month and one year, further increased by the presence of HPR (16.4%). On the other hand, among all patients with an SS <15, MACE rates remained low (<3%), irrespective of DM status and PR.<br />Conclusions: Among NSTE-ACS patients treated with PCI, the combination of DM, an SS ≥15 and HPR characterised a cohort with the highest MACE rate from one month to one year. In such high-risk patients, careful clinical monitoring and implementation of secondary prevention measures, including the use of potent P2Y12 inhibitors, are strongly advised.
- Subjects :
- Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary methods
Blood Platelets physiology
Clopidogrel
Diabetes Mellitus
Female
Humans
Male
Middle Aged
Ticlopidine analogs & derivatives
Ticlopidine therapeutic use
Treatment Outcome
Acute Coronary Syndrome therapy
Blood Platelets drug effects
Myocardial Infarction therapy
Percutaneous Coronary Intervention methods
Platelet Activation drug effects
Platelet Aggregation Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1969-6213
- Volume :
- 12
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 27320425
- Full Text :
- https://doi.org/10.4244/EIJV12I3A51