Related Experiment Video
Updated: Mar 11, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
High platelet reactivity affects the clinical outcomes of patients undergoing percutaneous coronary intervention
Jun-Jie Zhang1,2, Xiao-Fei Gao1, Zhen Ge1,2
1Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.
Insights
High platelet reactivity (HPR) on aspirin or clopidogrel significantly increases stent thrombosis risk in patients receiving drug-eluting stents (DESs). This finding highlights the importance of monitoring platelet function to improve clinical outcomes after DES implantation.
Area of Science:
- Cardiology
- Pharmacology
- Biomedical Engineering
Background:
- The relationship between platelet reactivity and clinical outcomes, particularly stent thrombosis after drug-eluting stent (DES) implantation, remains unclear.
- Understanding this association is crucial for optimizing antiplatelet therapy and patient management.
Purpose of the Study:
- To investigate the impact of high platelet reactivity (HPR) on clinical outcomes in patients undergoing DES implantation.
- To determine if HPR influences the incidence of stent thrombosis and major adverse cardiovascular and cerebrovascular events (MACCE).
Main Methods:
- A cohort of 1331 patients receiving DESs was evaluated using the PL-11 sequentially platelet counting method.
- The primary endpoint was stent thrombosis at 2 years; secondary endpoints included MACCE (all-cause death, myocardial infarction, target vessel revascularization, ischemic stroke).
Main Results:
- HPR on aspirin was identified in 6.8% and on clopidogrel in 32.9% of patients.
- Stent thrombosis incidence was significantly higher in patients with HPR on aspirin (9.9% vs. 0.4%) and clopidogrel (3.0% vs. 0.1%).
- MACCE rates were elevated in both HPR groups, driven by increased all-cause death and myocardial infarction in the HPR on aspirin group.
Conclusions:
- High platelet reactivity on both aspirin and clopidogrel is associated with a significant increase in stent thrombosis following DES implantation.
- These findings underscore the clinical relevance of assessing platelet reactivity in patients treated with DESs.
Background:
The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation.
Methods:
All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years. The secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all cause death, spontaneous myocardial infarction (MI), target vessel revascularization (TVR), and ischemic stroke.
Results:
A total of 1331consecutive patients were enrolled at our center. There were 91 patients (6.8 %) identified with high platelet reactivity (HPR) on aspirin, and 437 patients (32.9 %) with HPR on clopidogrel. At 2-year follow-up, the incidence of stent thrombosis was significantly higher in patients with HPR on aspirin (9.9 % vs. 0.4 %, p < 0.001), and HPR on clopidogrel (3.0 % vs. 0.1 %, p < 0.001). There were increased MACCE in the HPR on aspirin group (16.5 % vs. 8.5 %, p = 0.021), mainly driven by the higher all cause death (7.7 % vs. 1.6 %, p = 0.002) and MI (9.9 % vs. 1.9 %, p < 0.001) in the HPR on aspirin group. Similarly, the rate of MACCE was higher in the HPR on clopidogrel group (12.4 % vs. 7.4 %, p = 0.004). No differences in all bleeding and hemorrhagic stroke were observed.
Conclusions:
The present study demonstrated that high platelet reactivity on both aspirin and clopidogrel were associated with incremental stent thrombosis following DESs implantation.
More Related Videos
09:13Turbidimetry on Human Washed Platelets: The Effect of the Pannexin1-inhibitor Brilliant Blue FCF on Collagen-induced Aggregation
Published on: April 6, 2017
04:37Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation
Published on: May 23, 2025
Related Concept Videos
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:18Structure and Function of Platelets
Platelets are continually replenished, circulating in the bloodstream for 9-12 days before being removed by phagocytes, primarily in the spleen. A microliter of circulating blood contains between 150,000 and 450,000...
01:27Peripheral Artery Disease III: Interprofessional Care
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:27Coronary Artery Disease V: Interprofessional Care