Platelet Reactivity and Clinical Outcomes After Drug-Eluting Stent Implantation
- Authors
- Lee, Seung-Jun; Cha, Jung-Joon; Jeong, Young-Hoon; Hong, Sung-Jin; Ahn, Chul-Min; Kim, Jung-Sun; Ko, Young-Guk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo; Joo, Hyung Joon; Chang, Kiyuk; Park, Yongwhi; Song, Young Bin; Ahn, Sung Gyun; Suh, Jung-Won; Lee, Sang Yup; Cho, Jung Rae; Her, Ae-Young; Kim, Hyo-Soo; Kim, Moo Hyun; Shin, Eun-Seok; Lim, Do-Sun; Kim, Byeong-Keuk; PTRG Investigators
- Issue Date
- Nov-2022
- Publisher
- Elsevier BV
- Keywords
- drug-eluting stent(s); percutaneous coronary intervention; platelet function tests; stent thrombosis
- Citation
- JACC: Cardiovascular Interventions, v.15, no.22, pp 2253 - 2265
- Pages
- 13
- Indexed
- SCIE
SCOPUS
- Journal Title
- JACC: Cardiovascular Interventions
- Volume
- 15
- Number
- 22
- Start Page
- 2253
- End Page
- 2265
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62067
- DOI
- 10.1016/j.jcin.2022.09.007
- ISSN
- 1936-8798
1876-7605
- Abstract
- Background
The long-term prognostic implication of platelet reactivity after percutaneous coronary intervention (PCI) is not clearly known.
Objectives
The impacts of platelet reactivity from the PTRG-DES consortium were assessed.
Methods
The primary endpoint was the major adverse cardiac and cerebrovascular events (MACCE) including all-cause death, myocardial infarction, stent thrombosis, or stroke. Key secondary endpoints were all-cause mortality, major bleeding, and net adverse clinical events (NACE), including MACCE and bleeding.
Results
Between 2003 and 2018, a total of 11,714 patients were enrolled and grouped into tertiles according to P2Y12 reaction units (PRUs): high PRUs (≥253), intermediate PRUs (188-252), and low PRUs (<188). The Kaplan-Meier (KM) estimates of the primary outcome were significantly different across the groups; the high-PRU group showed the highest MACCE rate at 5 years (12.9%, 11.1%, and 7.0% in high-, intermediate-, and low-PRU groups, respectively; P < 0.001), as well as at 1 year (P < 0.001). The high-PRU group had the greatest KM estimates of all-cause death (8.2%, 5.9%, and 3.7%, respectively; P < 0.001) at 5 years without significant differences of major bleeding, and resultant of a higher KM estimates of NACE (15.7%, 13.6%, and 9.7%, respectively; P < 0.001). A PRU ≥252, the best cutoff value, was strongly related to MACCE (HR: 1.39; 95% CI: 1.11-1.74; P = 0.003) and all-cause death at 5 years after PCI (HR: 1.42; 95% CI: 1.04-1.94; P = 0.026). The optimal cutoff value of aspirin reaction units predicting the MACCE occurrence was ≥414 and was significantly associated with 5-year MACCE occurrence or all-cause death (P < 0.001).
Conclusions
In this large-scale cohort, high PRU was significantly associated with occurrence of MACCE, all-death death, and NACE at 5 years, as well as 1 year after PCI. (PTRG-DES Consortium [PTRG]; NCT04734028)
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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