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J A Mansurova1, L K Karazhanova

  • 1Semey State Medical University. mansurova_dzhami@mail.ru.

Kardiologiia
|January 10, 2019
PubMed
Summary
This summary is machine-generated.

High residual platelet reactivity (RPR) and low hemoglobin levels predict adverse cardiovascular events (ACVE) in acute coronary syndrome (ACS) patients post-stenting. Creatinine levels also emerged as a key predictor in this early in-hospital period.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Clinical Chemistry

Background:

  • Acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) with stenting are at risk for early in-hospital adverse cardiovascular events (ACVE).
  • Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is standard, but residual platelet reactivity (RPR) can still occur.
  • Predictors of ACVE in this high-risk population require further elucidation to optimize patient management.

Purpose of the Study:

  • To identify independent clinical and laboratory predictors of early in-hospital ACVE.
  • To assess the association between residual platelet reactivity (RPR) and ACVE after PCI with stenting.
  • To investigate the role of specific laboratory markers and genetic polymorphisms in predicting ACVE.

Main Methods:

Related Experiment Videos

  • Prospective single-center study of 130 ACS patients who underwent PCI with stenting.
  • Measurement of residual platelet reactivity (RPR) using light aggregometry 12-48 hours post-PCI.
  • Genotyping for CYP2C19*2 polymorphisms in 57 patients; monitoring of clinical outcomes including sudden death, stent thrombosis, and recurrent angina.

Main Results:

  • Adverse cardiovascular events (ACVE) were observed in 32 patients during the in-hospital period.
  • Independent predictors of ACVE included high ADP-induced RPR (>76%), elevated creatinine levels (>189 µmol/L), and low hemoglobin levels (<114 g/L).
  • Homozygous carriage of CYP2C19*2 (G681A) (A/A) was significantly associated with stent thrombosis.

Conclusions:

  • Residual platelet reactivity (RPR), creatinine, and hemoglobin levels are independent predictors of in-hospital ACVE following myocardial revascularization with stenting in ACS patients.
  • These findings highlight the importance of monitoring platelet function and key laboratory parameters for risk stratification.
  • CYP2C19*2 polymorphism may influence the risk of stent thrombosis in this patient cohort.