دورية أكاديمية

Monitoring Persistent Platelet Reactivity in Patients with Unprotected Left Main Stenting

التفاصيل البيبلوغرافية
العنوان: Monitoring Persistent Platelet Reactivity in Patients with Unprotected Left Main Stenting
المؤلفون: DILLINGER, JEAN‐GUILLAUME, SIDERIS, GEORGIOS, KCHAOU, IHEB, BAL DIT SOLLIER, CLAIRE, MANZO SILBERMAN, STEPHANE, VOICU, SEBASTIAN, MAGKOUTIS, NIKOLAOS, LOGEART, DAMIEN, DROUET, LUDOVIC, HENRY, PATRICK
المساهمون: Federation Française de Cardiologie (FFC)-Association de Cardiologie Ile de France
المصدر: Journal of Interventional Cardiology ; volume 26, issue 6, page 578-585 ; ISSN 0896-4327 1540-8183
بيانات النشر: Wiley
سنة النشر: 2013
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Objective This study sought to determine the rate and potential clinical impact of persistent platelet reactivity (PPR) in unprotected left main (ULMD) stenting. Background PPR under aspirin or thienopyridines is associated with acute events after angioplasty. Methods We prospectively included 125 patients referred for ULMD stenting. For the first 64 patients (ALMA‐1), angioplasty was performed under aspirin and clopidogrel without platelet reactivity assessment. For the last 61 patients (ALMA‐2), platelet reactivity was assessed before angioplasty: in patients with aspirin‐related PPR, aspirin twice daily was given and in those with clopidogrel‐related PPR, clopidogrel double dose or prasugrel was used. Results Overall, patients' mean age was 69 ± 13 years, 37% were diabetic, and 37% had non‐ST segment elevation myocardial infarction (NSTEMI). Patients' characteristics were similar in both studies with isolated left main in 14% and associated with 1‐, 2‐, or 3‐vessel disease in 23%, 36%, and 27%, respectively. Mean SYNTAX score was 23 ± 9. Procedural characteristics were similar using provisional T stenting in 69%, T stenting in 27%, and other techniques in 4%. In ALMA‐2, 28% patients had PPR for aspirin, 29% for clopidogrel, and 8% for both. Aspirin twice daily was given in 28% of patients, clopidogrel double dose in 26%, and prasugrel in 31%. The rate of 1‐year major adverse cardiovascular and cerebrovascular events (MACCE) was lower in ALMA‐2 versus ALMA‐1 (8.2% vs. 20.8%; P = 0.04) as a composite end‐point of cardiovascular death or stent thrombosis (0.0% vs. 8.3%; P = 0.02). Conclusion PPR under aspirin and thienopyridines is frequent in ULMD stenting and could be related to subsequent major events.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1111/joic.12076
الإتاحة: https://doi.org/10.1111/joic.12076Test
حقوق: http://onlinelibrary.wiley.com/termsAndConditions#vorTest
رقم الانضمام: edsbas.C84217CF
قاعدة البيانات: BASE