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POST-TREATMENT PLATELET FUNCTION PREDICTS MYOCARDIAL INJURY IN ACUTE MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PCI
Abstract number: P-T-574
Marcucci1 R., Paniccia1 R., Gori1 A., Antonucci1 E., Romano1 E., Poli1 S., Giglioli1 C., Prisco1 D., Gensini2 G., Abbate1 R.
11Surgical and Medical Critical Area 22Don Carlo gnocchi Foundation, University of Florence, Florence, Italy
How-to-cite Marcucci R, Paniccia R, Gori A, Antonucci E, Romano E, Poli S, Giglioli C, Prisco D, Gensini G, Abbate R. POST-TREATMENT PLATELET FUNCTION PREDICTS MYOCARDIAL INJURY IN ACUTE MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PCI. J Thromb Haemost 2007; 5 Supplement 2: P-T-574
Abstract
Introduction: We sought to evaluate if platelet function measured after PCI affects the severity of myocardial infarction (MI), measured by markers of cardiac necrosis in patients undergoing primary PCI. No data are available on patients with MI undergoing primary PCI.
Methods: We measured platelet function by both a point-of-care assay (PFA-100) and platelet rich-plasma aggregation by two agonists (arachidonic acid and ADP) in 247 patients with MI after PCI.
Results: 97 (39.3%) patients were found to be aspirin resistant by PFA-100 (CT/EPI <203 sec.). 98 (39.7%) patients were found to be aspirin resistant by platelet aggregation with arachidonic acid (AA-PA >=20%), 15/247 (6.0%) were found to be clopidogrel resistant by platelet aggregation with ADP 2 mmol (ADP-PA >=70%) and 74/247 (29.9%) by ADP 10 mM. CK-MB and cTnI mean peak values were significantly higher in the first tertile of CT/ADP and CT/EPI distribution with respect to the other tertiles and they were significantly higher in aspirin resistant than in aspirin sensitive patients. CK-MB and cTnI peak values were significantly higher in the third tertile of AA-PA, ADP2-PA and ADP10-PA distribution with respect to the other tertiles and were significantly higher in aspirin resistant patients. No significant differences were detected according to clopidogrel resistance by ADP 2 mM, whereas clopidogrel resistant patients by ADP 10 mM had significantly higher CK-MB and cTnI levels. Multivariate analysis revealed platelet function measured by PFA-100 (both CT/ADP and CT/EPI), platelet aggregation by AA and by ADP 10 mM, timeliness of percutaneous revascularization and multivessel disease to be independent predictors of CK-MB and cTnI peak values.
Conclusions: We found that a persistent platelet activation after revascularization procedure in patients with MI undergoing primary PCI affects the severity of MI independently of the other known clinical, procedural, and laboratory parameters.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
Session Details
| Date: |
01/08/2007
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| Time: |
00:00-00:00
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| Session name: |
XXIst ISTH Congress |
| Subject: |
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| Location: |
Oxford, UK |
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