Cardiovasc Drugs Ther
Cardiology Unit, ASL4 Liguria, Ospedali del Tigullio, Polo Di Lavagna, GE, Italy.
Published: August 2023
Purpose: This study aims to assess the association between body mass index (BMI) and platelet reactivity in STEMI patients treated with oral 3 generation P2Y inhibitors.
Methods: Overall, 429 STEMI patients were enrolled in this study. Patients were divided into two groups according to BMI (BMI < 25 vs ≥ 25 kg/m). A propensity score matching (1:1) was performed to balance potential confounders in patient baseline characteristics. Platelet reactivity was assessed by VerifyNow at baseline and after 3 generation P2Y inhibitor (ticagrelor or prasugrel) loading dose (LD). Blood samples were obtained at baseline (T0), 1 h (T1), 2 h (T2), 4-6 h (T3), and 8-12 h (T4) after the LD. High on-treatment platelet reactivity (HTPR) was defined as a platelet reactivity unit value ≥ 208 units.
Results: After propensity score matching, patients with BMI ≥ 25 had similar values of baseline platelet reactivity, while they had higher level of platelet reactivity at 1 and 2 h after the LD and higher rate of HRPT. Furthermore, multivariate analysis demonstrated that BMI ≥ 25 was an independent predictor of HTPR at 2 h (OR 2.01, p = .009). Conversely, starting from 4 h after the LD, platelet reactivity values and HRPT rates were comparable among the two study groups.
Conclusions: A BMI ≥ 25 kg/m is associated with delayed pharmacodynamic response to oral 3 generation P2Y inhibitor LD, and it is a strong predictor of HTPR in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel.
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http://dx.doi.org/10.1007/s10557-022-07322-2 | DOI Listing |
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