Impact of P2Y12 inhibition by clopidogrel on cardiovascular mortality in unselected patients treated by percutaneous coronary angioplasty: a prospective registry.
Fiche publication
Date publication
juin 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MEYER Nicolas
Tous les auteurs :
El Ghannudi S, Ohlmann P, Meyer N, Wiesel ML, Radulescu B, Chauvin M, Bareiss P, Gachet C, Morel O
Lien Pubmed
Résumé
OBJECTIVES: The aim of this study was to determine whether low platelet response to the P2Y(12) receptor antagonist clopidogrel as assessed by Vasodilator-stimulated phosphoprotein flow cytometry test (VASP- FCT) predicts cardiovascular events in a high-risk population undergoing percutaneous coronary intervention (PCI). BACKGROUND: Impaired platelet responsiveness to clopidogrel is thought to be a determinant of cardiovascular events after PCI. The platelet VASP-FCT is a new assay specific to the P2Y(12) adenosine diphosphate receptor-pathway. In this test, platelet activation is expressed as platelet reactivity index (PRI). METHODS: Four-hundred sixty-one unselected patients undergoing urgent (n = 346) or planned (n = 115) PCI were prospectively enrolled. Patients were classified as low-response (LR) and response (R) to clopidogrel, depending on their PRI. Optimal PRI cutoff was determined by receiver-operator characteristic curve analysis to 61% (LR: PRI > or =61% and R: PRI or =61%. The LR clinical impact seems to be dependent on the type of stent implanted.
Référence
JACC Cardiovasc Interv. 2010 Jun;3(6):648-56.