High platelet reactivity strongly predicts early stent thrombosis in patients with drug-eluting stent implantationopen access
- Authors
- Lim, Subin; Hong, Soon Jun; Kim, Ju Hyeon; Cha, Jung-Joon; Joo, Hyung Joon; Park, Jae Hyoung; Yu, Cheol Woong; Kim, Byeong-Keuk; Chang, Kiyuk; Park, Yongwhi; Song, Young Bin; Ahn, Sung Gyun; Suh, Jung-Won; Lee, Sang Yeub; Cho, Jung Rae; Her, Ae-Young; Jeong, Young-Hoon; Kim, Hyo-Soo; Kim, Moo Hyun; Shin, Eun-Seok; Lim, Do-Sun; Kim, Hyun Kuk; Lee, Jung Hee; Lee, Byoung Kwon; Kim, Weon; Park, Kyung Woo; Moon, Jae Yeon; Kwon, Osung; Kim, Chan Joon; Park, Hyun-Woong; Lee, Chang Hoon; Jang, Woo Jin; Jin, Han-Young; Chon, Min Ku; Choi, Ki Hong; Han, Dong Hoon; Kang, Min Gyu; Kang, Jeehoon; Ki, You Jeong; Park, Jin Sup; Lee, Seung-Jun; Lee, Seung Hun; Lee, Jong-Young; Cho, Sung Won; Suh, Jon; Bae, Jang-Whan; You, Seng Chan; Lim, Do-Sun; Jeong, Myung Ho
- Issue Date
- Jan-2024
- Publisher
- Nature Publishing Group
- Citation
- Scientific Reports, v.14, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- Scientific Reports
- Volume
- 14
- Number
- 1
- URI
- https://scholarworks.gnu.ac.kr/handle/sw.gnu/69428
- DOI
- 10.1038/s41598-023-50920-9
- ISSN
- 2045-2322
- Abstract
- Stent thrombosis (ST) is a fatal complication after percutaneous coronary intervention (PCI). The association between P2Y12 reaction unit (PRU) level and stent thrombosis occurrence remains unclear. Based on the multicenter, observational PTRG-DES (Platelet function and genoType-Related long-term proGnosis in DES-treated patients) registry of patients with drug-eluting stents (DES) implantation, a total of 11,714 patients with PRU values were analyzed. We sought to identify the predictors of early stent thrombosis (EST) and compared the primary outcome, a composite of cardiac death, myocardial infarction, and revascularization, between EST and non-EST groups. EST, defined as definite ST within 1 month after index PCI, occurred in 51 patients. PRU values were significantly higher in the EST group (263.5 ± 70.8 vs. 217.5 ± 78.7, p < 0.001). In multivariable analysis, PRU ≥ 252 (OR, 5.10; 95% CI 1.58–16.46; p = 0.006) and aspirin reaction unit ≥ 414 (OR 4.85; 95% CI 1.07–21.97; p = 0.040) were independent predictors of EST. The cumulative incidence of primary composite outcome at one year was significantly higher in the EST group (38.2% vs. 3.9%, Log-rank p < 0.001). In patients treated with clopidogrel after successful DES implantation, EST was associated with higher platelet reactivities, and a greater risk of cardiovascular events. Trial Registration: clinicaltrials.gov Identifier: NCT04734028. © 2024, The Author(s).
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