Coronary Artery DiseaseRelation Between Platelet Count and Platelet Reactivity to Thrombotic and Bleeding Risk: From the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents Study
Section snippets
Methods
ADAPT-DES was a prospective, nonrandomized, international, multicenter study designed to determine the incidence, timing, and predictors of ST after DES implantation.4 The major exclusion criteria were the occurrence of a serious adverse event during PCI or before platelet reactivity testing and planned bypass surgery after PCI. All patients received aspirin and clopidogrel before PCI. Platelet function tests were performed after successful PCI the day after the procedure by means of the
Results
Overall, 8,402 patients were included in the study cohort. Of them, 2,763 (32.9%), 2,828 (33.7%), and 2,811 patients (33.5%) were distributed across the lowest, intermediate, and highest PC tertile, respectively. PC interquartile range in the lowest tertile was 152 to 183, in the intermediate was 205 to 231, and in the highest was 261 to 315 (per 103/mm3). Baseline clinical characteristics are described in Table 1. Patients in the low tertile were older, more commonly men, of Caucasian
Discussion
The present analysis, drawn from more than 8,000 patients undergoing successful DES implantation, is to the best of our knowledge the largest study evaluating the relation between PC and PRU and their independent and combined effect on thrombotic, hemorrhagic, and mortality outcomes in an all-comers PCI population. The main findings of the present analysis include: (1) lower levels of PC were strongly and independently associated with higher residual platelet reactivity on clopidogrel; (2) high
Disclosures
Dr. Généreux receives Speaker's fee from Abbott Vascular and Edwards Lifescience; consulting fees from Cardiovascular Systems Inc.; and institutional research grant from Boston Scientific. Drs. Mehran and Dangas receives research grant support from Eli Lilly, AstraZeneca, The Medicines Company, BMS/Sanofi-Aventis; consulting fees from AstraZeneca, Bayer, CSL Behring, Janssen Pharmaceuticals, Merck, Osprey Medical Inc., Watermark Research Partners; and scientific advisory board from Abbott
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The ADAPT-DES study (NCT00638794) was sponsored by the Cardiovascular Research Foundation (New York, New York) and funded by research grants from Boston Scientific, Abbott Vascular, Medtronic, Cordis, Biosensors, The Medicines Company, Daiichi-Sankyo, Eli Lilly, Volcano, and Accumetrics.
See page 1712 for disclosure information.