On-Ticagrelor Platelet Reactivity and Clinical Outcome in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome.
Acute Coronary Syndrome
/ drug therapy
Aged
Blood Platelets
/ cytology
Cell Adhesion Molecules
/ metabolism
Female
Hemorrhage
Humans
Male
Microfilament Proteins
/ metabolism
Middle Aged
Percutaneous Coronary Intervention
/ methods
Phosphoproteins
/ metabolism
Platelet Activation
/ drug effects
Platelet Aggregation Inhibitors
/ therapeutic use
Platelet Function Tests
Prospective Studies
Purinergic P2Y Receptor Antagonists
/ chemistry
ST Elevation Myocardial Infarction
/ therapy
Ticagrelor
/ pharmacology
Treatment Outcome
Journal
Thrombosis and haemostasis
ISSN: 2567-689X
Titre abrégé: Thromb Haemost
Pays: Germany
ID NLM: 7608063
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
aheadofprint:
01
12
2020
pubmed:
2
12
2020
medline:
22
12
2021
entrez:
1
12
2020
Statut:
ppublish
Résumé
A strong association between on-thienopyridine platelet reactivity (PR) and the risk of both thrombotic and bleeding events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) has been demonstrated. However, no study has analyzed the relationship between on-ticagrelor PR and clinical outcome in this clinical setting. We aimed to investigate the relationship between on-ticagrelor PR, assessed by the vasodilator-stimulated phosphoprotein (VASP) index, and clinical outcome in patients with ACS undergoing PCI. We performed a prospective, multicenter, observational study of patients undergoing PCI for ACS. PR was measured using the VASP index following ticagrelor loading dose. The primary study endpoint was the rate of Bleeding Academic Research Consortium (BARC) type ≥2 at 1 year. The key secondary endpoint was the rate of major adverse cardiovascular events (MACE) defined as the composite of cardiovascular death, myocardial infarction, stroke, and urgent revascularization. We included 570 ACS patients, among whom 33.9% had ST-elevation myocardial infarction. BARC type ≥2 bleeding occurred in 10.9% and MACE in 13.8%. PR was not associated with BARC ≥2 or with MACE ( On-ticagrelor PR measured by the VASP was not associated with bleeding or thrombotic events in ACS patients undergoing PCI. PR measured by the VASP should not be used as a surrogate endpoint in studies on ticagrelor.
Sections du résumé
BACKGROUND
A strong association between on-thienopyridine platelet reactivity (PR) and the risk of both thrombotic and bleeding events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) has been demonstrated. However, no study has analyzed the relationship between on-ticagrelor PR and clinical outcome in this clinical setting.
OBJECTIVES
We aimed to investigate the relationship between on-ticagrelor PR, assessed by the vasodilator-stimulated phosphoprotein (VASP) index, and clinical outcome in patients with ACS undergoing PCI.
METHODS
We performed a prospective, multicenter, observational study of patients undergoing PCI for ACS. PR was measured using the VASP index following ticagrelor loading dose. The primary study endpoint was the rate of Bleeding Academic Research Consortium (BARC) type ≥2 at 1 year. The key secondary endpoint was the rate of major adverse cardiovascular events (MACE) defined as the composite of cardiovascular death, myocardial infarction, stroke, and urgent revascularization.
RESULTS
We included 570 ACS patients, among whom 33.9% had ST-elevation myocardial infarction. BARC type ≥2 bleeding occurred in 10.9% and MACE in 13.8%. PR was not associated with BARC ≥2 or with MACE (
CONCLUSION
On-ticagrelor PR measured by the VASP was not associated with bleeding or thrombotic events in ACS patients undergoing PCI. PR measured by the VASP should not be used as a surrogate endpoint in studies on ticagrelor.
Substances chimiques
Cell Adhesion Molecules
0
Microfilament Proteins
0
Phosphoproteins
0
Platelet Aggregation Inhibitors
0
Purinergic P2Y Receptor Antagonists
0
vasodilator-stimulated phosphoprotein
0
Ticagrelor
GLH0314RVC
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
923-930Subventions
Organisme : United States
ID : AstraZeneca
Pays : United States
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
M.L.: lecture fees and consulting fees from AstraZeneca; T.C.: consulting fees from Daiichi Sankyo and Eli Lilly and lecture fees from AstraZeneca, Abbott Vascular, Biotronik, Boston Scientific Corporation, Cordis Corporation, Daiichi Sankyo, Edwards Lifesciences, Eli Lilly, Iroko Cardio, Sanofi-Aventis, and Servier; V.P., C.F., C.G., B.J., M.-C.A. and J.M.: no conflict of interest concerning this article; Franck Paganelli: consulting fees from AstraZeneca; Laurent Bonello: lecture fees from AstraZeneca, Lilly, and Sanofi, and research grant from AstraZeneca.