AI Article Synopsis
- - Stent thrombosis (ST) is a serious complication after coronary artery procedures, and the link between P2Y12 reaction unit (PRU) levels and ST is still not fully understood.
- - Analysis of 11,714 patients from the PTRG-DES registry found that higher PRU and aspirin reaction unit levels are independent predictors of early stent thrombosis (EST), which occurred in 51 patients.
- - The risk of major cardiovascular events within a year was significantly greater for those who had EST (38.2%) compared to those who did not (3.9%), highlighting the importance of monitoring platelet activity after drug-eluting stent procedures.
Article Abstract
Stent thrombosis (ST) is a fatal complication after percutaneous coronary intervention (PCI). The association between P2Y12 reaction unit (PRU) level and stent thrombosis occurrence remains unclear. Based on the multicenter, observational PTRG-DES (Platelet function and genoType-Related long-term proGnosis in DES-treated patients) registry of patients with drug-eluting stents (DES) implantation, a total of 11,714 patients with PRU values were analyzed. We sought to identify the predictors of early stent thrombosis (EST) and compared the primary outcome, a composite of cardiac death, myocardial infarction, and revascularization, between EST and non-EST groups. EST, defined as definite ST within 1 month after index PCI, occurred in 51 patients. PRU values were significantly higher in the EST group (263.5 ± 70.8 vs. 217.5 ± 78.7, p < 0.001). In multivariable analysis, PRU ≥ 252 (OR, 5.10; 95% CI 1.58-16.46; p = 0.006) and aspirin reaction unit ≥ 414 (OR 4.85; 95% CI 1.07-21.97; p = 0.040) were independent predictors of EST. The cumulative incidence of primary composite outcome at one year was significantly higher in the EST group (38.2% vs. 3.9%, Log-rank p < 0.001). In patients treated with clopidogrel after successful DES implantation, EST was associated with higher platelet reactivities, and a greater risk of cardiovascular events.Trial Registration: clinicaltrials.gov Identifier: NCT04734028.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10766995 | PMC |
| http://dx.doi.org/10.1038/s41598-023-50920-9 | DOI Listing |
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