Aspirin Treatment and Outcomes After Percutaneous Coronary Intervention Results of the ISAR-ASPI Registry

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:64

Article

Mayer, Katharina¹  Bernlochner, Isabell²  Braun, Siegmund¹  Schulz, Stefanie¹  Orban, Martin³  Morath, Tanja¹  Cala, Lisena¹  Hoppmann, Petra²  Schunkert, Heribert^1,4  Laugwitz, Karl-Ludwig^2,4  Kastrati, Adnan^1,4  Sibbing, Dirk^3,4 

[1] Tech Univ Munich, Deutsch Herzzentrum Munchen, D-80290 Munich, Germany

[2] Tech Univ Munich, Klinikum Rechts Isar, Med Klin 1, D-80290 Munich, Germany

[3] Univ Munich, Dept Cardiol, Munich, Germany

[4] DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany

关键词: aspirin;    biomarker;    high platelet reactivity;    stent thrombosis;   

DOI  :  10.1016/j.jacc.2014.05.049

来源: Elsevier

【 摘 要 】

BACKGROUND Aspirin administration, as part of a dual antiplatelet treatment regimen, is essential for patients undergoing percutaneous coronary intervention (PCI). Although the correlation between high on-clopidogrel treatment platelet reactivity (HCPR) and clinical outcome is well established, data for high on-aspirin treatment platelet reactivity (HAPR) are conflicting. OBJECTIVES The aim of the ISAR-ASPI (Intracoronary Stenting and Antithrombotic Regimen-ASpirin and Platelet Inhibition) registry was to assess the value of HAPR as a possible prognostic biomarker in PCI-treated patients with regard to clinical outcome. METHODS From February 2007 to May 2013, we identified 7,090 consecutive PCI-treated patients with measured on-aspirin treatment platelet aggregation values directly before PCI. Platelet function was assessed with a Multiplate analyzer. The primary endpoint was death or stent thrombosis (ST) at 1 year. RESULTS The upper quintile of patients (n = 1,414), according to Multiplate measurements, was defined as the HAPR cohort. Compared with non-HAPR patients (n = 5,676), HAPR patients showed a significantly higher risk of death or ST at 1 year (6.2% vs. 3.7%, respectively; odds ratio [OR]: 1.78; 95% confidence interval [CI]: 1.39 to 2.27; p < 0.0001). HAPR was found to be an independent predictor of the primary outcome (adjusted hazard ratio [HRadj]: 1.46; 95% CI: 1.12 to 1.89; p = 0.005). CONCLUSIONS HAPR, measured at the time point of the PCI, is associated with a higher risk for death or ST during the first year after PCI. Present data are in support of the addition of HAPR to a panel of prognostic biomarkers in PCI-treated patients. (C) 2014 by the American College of Cardiology Foundation.

【 授权许可】

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