[Predictive value of serial platelet function testing on outcome in patients undergoing complex percutaneous coronary...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Clinical Trials

Background:

• Complex percutaneous coronary intervention (PCI) requires effective antiplatelet therapy.
• Monitoring platelet function is crucial for optimizing treatment and predicting outcomes.
• High on-treatment platelet reactivity (HTPR) is a concern in patients undergoing PCI.

Purpose of the Study:

• To evaluate the predictive value of serial platelet function testing (PFT) for clinical outcomes in patients undergoing complex PCI.
• To determine if HTPR is an independent risk factor for major adverse cardiovascular and cerebral events (MACCE) after complex PCI.

Main Methods:

• A cohort of 602 patients undergoing complex PCI were enrolled.
• Adenosine diphosphate (ADP)-induced platelet aggregation was measured serially using light transmission aggregometry.
• High on-treatment platelet reactivity (HTPR) was defined as ≥40% aggregation; MACCE was the primary endpoint.

Main Results:

• Five hundred and eighty-five patients completed follow-up (mean 28.47 months).
• HTPR (n=285) was associated with a significantly higher incidence of MACCE (8.42%) compared to non-HTPR (n=280, 3.21%) (P=0.01).
• HTPR was identified as an independent risk factor for MACCE (HR=2.69, P=0.01).

Conclusions:

• Serial PFT is a valuable tool for predicting long-term prognosis in patients after complex PCI.
• HTPR is an independent predictor of adverse cardiovascular and cerebral events in this patient population.
• The duration of dual antiplatelet therapy (DAPT) did not significantly impact MACCE rates in HTPR patients.