دورية أكاديمية
High on-treatment platelet reactivity and outcome in elderly with non ST-segment elevation acute coronary syndrome - Insight from the GEPRESS study
| العنوان: | High on-treatment platelet reactivity and outcome in elderly with non ST-segment elevation acute coronary syndrome - Insight from the GEPRESS study |
|---|---|
| المؤلفون: | De Rosa, Roberta, Palmerini, Tullio, De Servi, Stefano, Belmonte, Marta, Crimi, Gabriele, Cornara, Stefano, Calabrò, Paolo, Cattaneo, Marco, Maffeo, Diego, Toso, Anna, Bartorelli, Antonio, Palmieri, Cataldo, De Carlo, Marco, Capodanno, Davide, Genereux, Philippe, Angiolillo, Dominick, Piscione, Federico, Galasso, Gennaro |
| المساهمون: | De Rosa, Roberta, Palmerini, Tullio, De Servi, Stefano, Belmonte, Marta, Crimi, Gabriele, Cornara, Stefano, Calabrò, Paolo, Cattaneo, Marco, Maffeo, Diego, Toso, Anna, Bartorelli, Antonio, Palmieri, Cataldo, De Carlo, Marco, Capodanno, Davide, Genereux, Philippe, Angiolillo, Dominick, Piscione, Federico, Galasso, Gennaro |
| بيانات النشر: | ELSEVIER IRELAND LTD CLARE ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND |
| سنة النشر: | 2018 |
| المجموعة: | Università degli Studi della Campania "Luigi Vanvitelli": CINECA IRIS V: |
| مصطلحات موضوعية: | Clopidogrel, Elderly, Non-ST-elevated acute coronary syndrome, Platelet reactivity |
| الوصف: | Background: Elderly treated with dual antiplatelet therapy after percutaneous coronary intervention (PCI) represent a challenging population because of increased risk of both ischemic and bleeding events. We aimed to investigate the association between high on-treatment platelet reactivity (HPR) and long-term outcome in elderly with non-ST-elevated acute coronary syndromes (NSTE-ACS) undergoing PCI.Methods: Platelet reactivity was measured by vasodilator-stimulated phosphoprotein (VASP) assay at three time points (baseline, discharge, 1 month after PCI) in 1053 NSTE-ACS patients (311 elderly) treated with clopidogrel. Major adverse cardiac events (MACE) were assessed up to 1 year-follow-up.Results: Elderly with HPR at discharge showed a significantly higher incidence of overall MACE (13 vs 4%, p=.006), cardiac death (6 vs 0.7%, p=.020), myocardial infarction (MI, 12 vs 4%, p=.031) and a trend for higher stent-thrombosis (5 vs 0.7%, p=.068). Similarly, elderly with 1-month-HPR showed between 1 month and 1 year significantly higher incidence of MACE (10 vs 4%, p=.012), cardiac death (6 vs 0.7%, p=.019) and composite cardiac death/MI (11 vs 4%, p=.014). Up to 1 year, elderly with HPR showed a 4-fold increased risk of MACE compared to both elderly without HPR (for discharge-HPR: p =. 005; for 1-month-HPR: p =. 01) and non-elderly with HPR (for discharge-HPR: p<.001; for 1-month-HPR: p<.0001). At multivariable analysis, HPR could independently predict 1-year-MACE in elderly (for discharge-HPR: HR=3.191, CI: 1.373-7.417, p=.007; for 1-month-HPR: HR=3.542, CI: 1.373-9.137, p=. 009).Conclusions: In elderly with NSTE-ACS undergoing PCI and treated with clopidogrel, HPR was independently associated with an increased risk of MACE up to 1 year. (c) 2018 Elsevier B.V. All rights reserved. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/29579602; info:eu-repo/semantics/altIdentifier/wos/WOS:000428300900004; volume:259; firstpage:20; lastpage:25; numberofpages:6; journal:INTERNATIONAL JOURNAL OF CARDIOLOGY; http://hdl.handle.net/11591/394032Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85044132565; www.elsevier.com/locate/ijcard |
| DOI: | 10.1016/j.ijcard.2018.01.057 |
| الإتاحة: | https://doi.org/10.1016/j.ijcard.2018.01.057Test http://hdl.handle.net/11591/394032Test |
| رقم الانضمام: | edsbas.FD5093 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.ijcard.2018.01.057 |
|---|