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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation
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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation

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Relationship Between Platelet Reactivity and Periprocedural Myonecrosis in Patients Undergoing Percutaneous Coronary

Sun Young Choi1, Moo Hyun Kim, Kyung-Yae Hyun

  • 1Department of Cardiology, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan, South Korea 602-715. kimmh@dau.ac.kr.

The Journal of Invasive Cardiology
|December 2, 2019
PubMed

Insights

High platelet reactivity before percutaneous coronary intervention (PCI) increases the risk of periprocedural myonecrosis (PMN) in East Asian patients. Optimizing platelet reactivity may reduce PMN incidence in these patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Platelet Physiology

Background:

  • The relationship between platelet reactivity and periprocedural myonecrosis (PMN) in East Asian patients undergoing percutaneous coronary intervention (PCI) remains unclear.
  • East Asian patients with stable ischemic heart disease or non-ST elevation acute coronary syndrome are a key demographic for this investigation.

Purpose of the Study:

  • To investigate the impact of pre-procedural platelet reactivity on PMN in East Asian patients undergoing PCI.
  • To determine if high platelet reactivity (HPR) is an independent predictor of PMN.

Main Methods:

  • 256 East Asian patients with normal baseline high-sensitivity troponin I levels undergoing PCI were enrolled.
  • Residual platelet reactivity was measured using the VerifyNow P2Y12 assay pre-PCI and 18-24 hours post-PCI.
  • High platelet reactivity (HPR) was defined using platelet reactivity units (PRUs) with cut-off scores of >208, >235, and >272; PMN was defined as troponin I elevation >5x the 99th percentile URL.

Main Results:

  • The overall rate of PMN was 55.9%.
  • Higher pre-PCI and post-PCI PRU values were significantly associated with increased PMN rates.
  • Pre-procedural HPR (PRU >208) was identified as an independent predictor of PMN (OR, 3.39; P<.001).

Conclusions:

  • Pre-procedural high platelet reactivity (HPR) is linked to a higher risk of PMN in East Asian patients undergoing PCI.
  • Achieving optimal platelet reactivity prior to PCI may be a strategy to mitigate the risk of PMN.
Abstract

Keywords:
VerifyNowmyocardial injurypercutaneous coronary interventionplatelets

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