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Erschienen in:

07.07.2016

High platelet reactivity after P2Y₁₂-inhibition in patients with atrial fibrillation and coronary stenting

verfasst von: Jonathan Rilinger, Melanie Meyer, Katharina Schnabel, Patrick Weik, Anne Charlet, Jennifer S. Esser, Qian Zhou, Christoph Bode, Martin Moser, Philipp Diehl, Christoph B. Olivier

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 4/2016

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Abstract

High platelet reactivity (HPR) after P2Y₁₂-inhibition in patients undergoing coronary stenting is associated with an increased risk for thromboembolic events and coronary death. So far it is not known how HPR affects the clinical outcome of different treatment strategies in patients with atrial fibrillation (AF) undergoing coronary stenting. In this single centre, observational study the antiplatelet effect of P2Y₁₂-inhibitors in AF patients undergoing coronary stenting was investigated using impedance aggregometry. Patients received either dual antiplatelet therapy (DAPT) or triple therapy (TT). HPR was defined as the ratio of ADP-to TRAP-induced aggregation (r-ADP-agg) ≥50 %. Thromboembolic and bleeding events were assessed within the first 30 days after stenting. Out of 910 screened patients 167 patients were available for the present analysis. HPR was found in 5 of 43 (12 %) patients treated with DAPT and in 18 of 124 (15 %) patients treated with TT. In patients receiving TT, HPR was not a risk factor for thromboembolic events compared to patients with adequate response to P2Y₁₂-inhibitors (6 vs. 8 %, p = 0.712). There was a trend for less bleeding events in patients with HPR compared to r-ADP-agg <50 % in the TT group (0 vs. 16 %, p = 0.077). Our data suggest that HPR after P2Y₁₂-antagonism in patients receiving TT due to AF and coronary stenting might protect from bleeding without increasing thromboembolic risk. Future studies will need to investigate if patients with AF receiving coronary stenting benefit from a reduction of antithrombotic therapy.

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Titel: High platelet reactivity after P2Y12-inhibition in patients with atrial fibrillation and coronary stenting
verfasst von: Jonathan Rilinger
Melanie Meyer
Katharina Schnabel
Patrick Weik
Anne Charlet
Jennifer S. Esser
Qian Zhou
Christoph Bode
Martin Moser
Philipp Diehl
Christoph B. Olivier
Publikationsdatum: 07.07.2016
Verlag: Springer US
Erschienen in: Journal of Thrombosis and Thrombolysis / Ausgabe 4/2016
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-016-1397-5

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