IMPACT OF HIGH ON-TREATMENT PLATELET REACTIVITY ON 5-YEAR MORTALITY IN PATIENTS AFTER MYOCARDIAL INFARCTION
Author(s): ,
Martin Jakl
Affiliations:
Department of Military Internal Medicine and Military Hygiene,University of Defense, Faculty of Military Health Sciences, Hradec Kralove, Czech Republic,Hradec Kralove,Czech Republic;1st Department of Internal Medicine - Cardioangiology,University Hospita
,
Robert Sevcik
Affiliations:
Hjärtkliniken NÄL,NU-Sjukvården,Trollhättan,Sweden
,
Ilona Fatorova
Affiliations:
4th Department of Internal Medicine - Hematology,University Hospital and Charles University, Faculty of Medicine,Hradec Kralove,Czech Republic
Jan M Horacek
Affiliations:
Department of Military Internal Medicine and Military Hygiene,University of Defense, Faculty of Military Health Sciences, Hradec Kralove, Czech Republic,Hradec Kralove,Czech Republic;4th Department of Internal Medicine - Hematology,University Hospital and
EHA Library. M Horacek J. 06/12/15; 100645; P408
Assoc. Prof. Jan M Horacek
Assoc. Prof. Jan M Horacek
Contributions
Abstract
Abstract: P408

Type: Poster Presentation

Presentation during EHA20: From 12.06.2015 17:15 to 12.06.2015 18:45

Location: Poster area (Hall C)

Background
High on-treatment platelet reactivity (HTPR) is expected to be a negative prognostic factor in patients with coronary artery disease. However, long-term results in patients with acute myocardial infarction are lacking.

Aims
The aim of the study was to assess the relationship between HTPR and five-year mortality in patients with acute myocardial infarction.

Methods
We performed a prospective cohort study of 198 patients with acute myocardial infarction. In these patients, the response to aspirin and clopidogrel was assessed by impedance aggregometry. According to their response to antiplatelet treatment, the patients were divided into groups with adequate response, dual poor responsiveness (DPR), poor responsiveness to aspirin (PRA) and poor responsiveness to clopidogrel (PRC). After five years, the myocardial infarction recurrence and overall mortality were assessed.

Results
Five-year mortality was significantly higher in all groups of patients with HTPR compared with patients with sufficient response to antiplatelet treatment: in PRA patients 38.1 % vs. 19.2 %, p <0.01, in PRC patients 45.2 % vs. 17.3 %, p<0.001 and in DPR patients 50.0 % vs. 19.9 %, p<0.05. Risk of repeated myocardial infarction was also increased (HR 4.0, 95 % CI 1.25-11.5, p<0.05 for DPR, HR 4.37, 95 % CI 1.51-12.77, p<0.01 for PRA, HR 3.25, 95 % CI 1.11-9.36, p<0.05 for PRC). In a multivariable analysis, HTPR and left ventricle systolic dysfunction were proven to be independent predictors of mortality.

Summary
PRA, PRA and DPR are independent predictors of increased five-year mortality and risk of repeated myocardial infarction.

Keyword(s): Mortality, Myocardial infarction, Platelet reactivity



Session topic: Procoagulant states
Abstract: P408

Type: Poster Presentation

Presentation during EHA20: From 12.06.2015 17:15 to 12.06.2015 18:45

Location: Poster area (Hall C)

Background
High on-treatment platelet reactivity (HTPR) is expected to be a negative prognostic factor in patients with coronary artery disease. However, long-term results in patients with acute myocardial infarction are lacking.

Aims
The aim of the study was to assess the relationship between HTPR and five-year mortality in patients with acute myocardial infarction.

Methods
We performed a prospective cohort study of 198 patients with acute myocardial infarction. In these patients, the response to aspirin and clopidogrel was assessed by impedance aggregometry. According to their response to antiplatelet treatment, the patients were divided into groups with adequate response, dual poor responsiveness (DPR), poor responsiveness to aspirin (PRA) and poor responsiveness to clopidogrel (PRC). After five years, the myocardial infarction recurrence and overall mortality were assessed.

Results
Five-year mortality was significantly higher in all groups of patients with HTPR compared with patients with sufficient response to antiplatelet treatment: in PRA patients 38.1 % vs. 19.2 %, p <0.01, in PRC patients 45.2 % vs. 17.3 %, p<0.001 and in DPR patients 50.0 % vs. 19.9 %, p<0.05. Risk of repeated myocardial infarction was also increased (HR 4.0, 95 % CI 1.25-11.5, p<0.05 for DPR, HR 4.37, 95 % CI 1.51-12.77, p<0.01 for PRA, HR 3.25, 95 % CI 1.11-9.36, p<0.05 for PRC). In a multivariable analysis, HTPR and left ventricle systolic dysfunction were proven to be independent predictors of mortality.

Summary
PRA, PRA and DPR are independent predictors of increased five-year mortality and risk of repeated myocardial infarction.

Keyword(s): Mortality, Myocardial infarction, Platelet reactivity



Session topic: Procoagulant states

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