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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
- 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.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 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 P2Y(12) inhibitors, are strongly advised.
- Subjects :
- Blood Platelets
Male
Acute coronary syndrome
medicine.medical_specialty
Ticlopidine
medicine.medical_treatment
Myocardial Infarction
030204 cardiovascular system & hematology
Acute coronary syndromes
Diabete
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Internal medicine
Clopidogrel
Diabetes
SYNTAX score
Cardiology and Cardiovascular Medicine
Diabetes Mellitus
medicine
Humans
030212 general & internal medicine
Myocardial infarction
Platelet activation
cardiovascular diseases
Angioplasty, Balloon, Coronary
Aged
Aged, 80 and over
business.industry
Percutaneous coronary intervention
Middle Aged
Platelet Activation
medicine.disease
Treatment Outcome
Conventional PCI
Cardiology
Platelet aggregation inhibitor
Female
business
Platelet Aggregation Inhibitors
Mace
medicine.drug
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....7c1d478a5ff4972f40cbd3f09d900d95