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High on treatment platelet reactivity and stent thrombosis

Saissan Rajendran1, Devang Parikh, Ibrahim Shugman

  • 1University of NSW, Sydney, Australia.

Heart, Lung & Circulation
|May 20, 2011
PubMed

Insights

High platelet reactivity to aspirin and clopidogrel is common in patients with stent thrombosis. Doubling antiplatelet dosage can improve platelet inhibition and reduce this risk.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis Research

Background:

  • Stent thrombosis (ST) is a serious complication following percutaneous coronary intervention (PCI).
  • High on-treatment platelet reactivity (HTPR) is a suspected risk factor for ST.
  • Understanding the relationship between HTPR and ST is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the association between HTPR and the incidence of ST.
  • To evaluate the efficacy of increased antiplatelet therapy dosage in overcoming HTPR.

Main Methods:

  • Compared clinical characteristics and platelet reactivity (using VerifyNow assays) in patients with ST versus those without.
  • Assessed platelet reactivity before and after a two-week course of double-dose antiplatelet therapy in patients with HTPR.

Main Results:

  • Significantly higher prevalence of HTPR (aspirin and/or clopidogrel) in ST patients (75%) compared to controls (2.5%).
  • ST patients were younger, had more coronary artery disease, and smaller reference vessel diameters.
  • Double-dose therapy significantly improved platelet reactivity in most patients with initial HTPR.

Conclusions:

  • HTPR is frequently observed in patients experiencing stent thrombosis.
  • Increasing the dosage of aspirin and clopidogrel can effectively enhance platelet inhibition in non-responsive patients.
Abstract

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