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Insufficient platelet inhibition is related to silent embolic cerebral infarctions after coronary angiography

Bum Joon Kim1, Seung-Whan Lee, Seong-Wook Park

  • 1Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.

Stroke
|December 31, 2011
PubMed

Insights

Insufficient platelet inhibition from antiplatelet agents is linked to silent embolic cerebral infarction (SECI) after coronary angiography. Higher resistance to these medications increases SECI risk, highlighting the importance of adequate platelet inhibition.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Insufficient platelet inhibition is a known risk factor for thrombotic complications.
  • Coronary angiography procedures carry a risk of embolic events.

Purpose of the Study:

  • To investigate the relationship between the extent of platelet inhibition and silent embolic cerebral infarction (SECI) after coronary angiography.
  • To determine if inadequate platelet inhibition by antiplatelet agents is associated with SECI.

Main Methods:

  • Retrospective analysis of 272 patients undergoing coronary angiography (Phase 1).
  • Prospective study of 102 patients measuring platelet inhibition using the VerifyNow system (Phase 2).
  • Diffusion-weighted imaging used to detect SECI.

Main Results:

  • SECI occurred in 16.5% (Phase 1) and 16.7% (Phase 2) of patients.
  • Patients with SECI had higher aspirin and P2Y12 reaction units, indicating poorer platelet inhibition.
  • Increased SECI incidence correlated with resistance to antiplatelet agents.

Conclusions:

  • Inadequate platelet inhibition following antiplatelet therapy is associated with SECI after coronary angiography.
  • Nonresponsiveness to antiplatelet agents is an independent risk factor for SECI.
Abstract

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