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A case-control study on platelet reactivity in patients with coronary stent thrombosis

H J Bouman1, J W van Werkum, N J Breet

  • 1St Antonius Center for Platelet Function Research, St Antonius Hospital, Nieuwegein, The Netherlands.

Journal of Thrombosis and Haemostasis : JTH
|March 9, 2011
PubMed

Insights

Patients with early stent thrombosis (ST) show poor response to clopidogrel. Both early and late ST are linked to increased aspirin reactivity and higher dual antiplatelet therapy resistance.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis Research

Background:

  • Stent thrombosis (ST) pathophysiology is a complex multifactorial model.
  • Understanding platelet reactivity is crucial for managing ST.
  • Previous research focused on single causative factors for ST.

Purpose of the Study:

  • To investigate heightened platelet reactivity in patients with a history of stent thrombosis (ST).
  • To assess platelet response to clopidogrel and aspirin in ST patients.
  • To determine the prevalence of dual antiplatelet therapy resistance in ST survivors.

Main Methods:

  • Compared platelet reactivity in 84 ST patients (41 early, 43 late) versus 103 controls.
  • Assessed platelet function using optical aggregometry, VerifyNow P2Y12/aspirin, PFA-100, VASP assay, and urine 11-dehydrothromboxane B2.
  • Measured reactivity before and after clopidogrel and aspirin loading doses.

Main Results:

  • Early ST patients showed significantly higher on-clopidogrel platelet reactivity than controls.
  • Both early and late ST patients exhibited heightened on-aspirin platelet reactivity.
  • Dual antiplatelet therapy resistance was more frequent in ST patients.

Conclusions:

  • Early ST is associated with a poor response to clopidogrel.
  • Both early and late ST are independently linked to heightened on-aspirin platelet reactivity.
  • Increased dual antiplatelet therapy resistance is a significant finding in ST patients.
Abstract

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