Platelet Function Tests Show Reduced Clopidogrel Response in Stent Thrombosis Patients
Author Information
Author(s): Hobson Alex R, Petley Graham, Morton Geraint, Dawkins Keith D, Curzen Nick P
Primary Institution: Wessex Cardiac Unit, Southampton University Hospital, Southampton, UK
Hypothesis
Point-of-care assays of platelet reactivity would demonstrate reduced response to antiplatelet therapy in patients who experienced Drug Eluting Stent (DES) ST whilst on dual antiplatelet therapy compared to matched DES controls.
Conclusion
This study demonstrates reduced platelet response to clopidogrel in some patients with DES ST compared to matched controls.
Supporting Evidence
- 57% of the ST group by TEG had results > two standard deviations above the expected mean in the control group.
- 43% of the ST cases by Accumetrics PRU had results > two standard deviations above the expected mean in the control group.
- The study found significantly greater platelet reactivity on clopidogrel in the ST group using the Accumetrics P2Y12 assay.
Takeaway
Some patients who had problems with their heart stents didn't respond well to a blood thinner called clopidogrel, but they were fine with another one called aspirin.
Methodology
Seven patients with Drug Eluting Stent thrombosis were matched with two controls each, and platelet reactivity was assessed using Thrombelastogram PlateletMapping™ and VerifyNow assays.
Potential Biases
The retrospective nature of the study may introduce bias due to the absence of data from patients who died from stent thrombosis.
Limitations
The study had a small number of stent thrombosis patients and lacked baseline samples prior to antiplatelet therapy.
Participant Demographics
The study included 7 patients with DES ST and 14 matched controls, with no significant differences in demographics.
Statistical Information
P-Value
0.02
Statistical Significance
p = 0.02
Digital Object Identifier (DOI)
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