Relationship between platelet aggregation and stroke risk after percutaneous coronary intervention: a PENDULUM analysis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2022-01-01

AUTHORS

Yuji Matsumaru, Takanari Kitazono, Kazushige Kadota, Koichi Nakao, Yoshihisa Nakagawa, Junya Shite, Hiroyoshi Yokoi, Ken Kozuma, Kengo Tanabe, Takashi Akasaka, Toshiro Shinke, Takafumi Ueno, Atsushi Hirayama, Shiro Uemura, Takeshi Kuroda, Atsushi Takita, Atsushi Harada, Raisuke Iijima, Yoshitaka Murakami, Shigeru Saito, Masato Nakamura

ABSTRACT

In patients undergoing percutaneous coronary intervention (PCI) with a stent, high on-treatment platelet reactivity may be associated with an increased risk of stroke. This post hoc analysis of the PENDULUM registry compared the risk of post-PCI stroke according to on-treatment P2Y12 reaction unit (PRU) values. Patients aged ≥ 20 years who underwent PCI were stratified by baseline PRU (at 12 and 48 h post-PCI) as either high (HPR, > 208), optimal (OPR, > 85 to ≤ 208), or low on-treatment platelet reactivity (LPR, ≤ 85). The incidences of non-fatal ischemic and non-ischemic stroke through to 12 months post-PCI were recorded. Almost all enrolled patients (6102/6267 [97.4%]) had a risk factor for ischemic stroke, and most were receiving dual antiplatelet therapy. Of the 5906 patients with PRU data (HPR, n = 2227; OPR, n = 3002; LPR, n = 677), 47 had a non-fatal stroke post-PCI (cumulative incidence: 0.68%, ischemic; 0.18%, non-ischemic stroke). Patients with a non-fatal ischemic stroke event had statistically significantly higher post-PCI PRU values versus those without an event (P = 0.037). The incidence of non-fatal non-ischemic stroke was not related to PRU value. When the patients were stratified by PRU ≤ 153 versus > 153 at 12–48 h post-PCI, a significant difference was observed in the cumulative incidence of non-fatal stroke at 12 months (P = 0.044). We found that patients with ischemic stroke tended to have higher PRU values at 12–48 h after PCI versus those without ischemic stroke.Clinical trial registration: UMIN000020332. More... »

PAGES

942-953

Journal

TITLE

Heart and Vessels

ISSUE

6

VOLUME

37

Author Affiliations

  • Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki, Japan
  • Department of Clinical Medicine, National University Corporation Kyushu University, Fukuoka, Japan
  • Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
  • Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan
  • Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
  • Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
  • Cardiovascular Medicine Center, Fukuoka Sanno Hospital, Fukuoka, Japan
  • Division of Cardiology, Department of Internal Medicine, Teikyo University, Tokyo, Japan
  • Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
  • Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
  • Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
  • Department of Cardiovascular Medicine, Fukuoka Kinen Hospital, Fukuoka, Japan
  • Department of Cardiology, Osaka Police Hospital, Osaka, Japan
  • Department of Cardiology, Kawasaki Medical School, Okayama, Japan
  • Medical Science Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan
  • Data Intelligence Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan
  • Medical Information Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan
  • Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
  • Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
  • Division of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00380-021-02003-w

    DOI

    http://dx.doi.org/10.1007/s00380-021-02003-w

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1144338970

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34973085


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