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Parathyroid Hormone Levels and High-Residual Platelet Reactivity in Patients Receiving Dual Antiplatelet Therapy With Acetylsalicylic Acid and Clopidogrel or Ticagrelor
| Content Provider | Scilit |
|---|---|
| Author | Verdoia, Monica Pergolini, Patrizia Rolla, Roberta Nardin, Matteo Barbieri, Lucia Schaffer, Alon Bellomo, Giorgio Marino, Paolo Suryapranata, Harry Luca, Giuseppe De |
| Copyright Year | 2016 |
| Description | Journal: Cardiovascular Therapeutics BackgroundHigh on treatment platelet reactivity still represents a challenging issue, potentially vanishing the benefits of dual antiplatelet treatment in patients with coronary artery disease. However, very few is known on the determinants of suboptimal response to antiplatelet agents. Recent interests have emerged on the potential protrombotic effect of parathyroid hormone (PTH). Therefore, the aim of the present study was to assess the impact of parathyroid hormone (PTH) on platelet reactivity in patients receiving DAPT after an acute coronary syndrome or PCI.MethodsPatients treated with DAPT (ASA and clopidogrel or ticagrelor) were scheduled for platelet function assessment at 30-90 days post-discharge. By whole blood impedance aggregometry, HRPR was considered for ASPI test > 862 AU*min (for ASA) and ADP test values >417 AU*min (for ADP-antagonists).ResultsWe included 362 patients on DAPT, 125 (34.5%) receiving clopidogrel and 237 (65.5%) on ticagrelor. Patients were divided according to PTH quartiles values (96.7 pg/ml among the subgroup of patients on clopidogrel (51.5 vs 85.7%, p=0.001; adjusted OR[95%CI]=12.5[2.6-60.9], p=0.002), but not among ticagrelor treated patients (11.3 vs 16.7%, p=0.31; adjusted OR[95%CI]=1.55[0.56-4.6], p=0.42).ConclusionIn patients receiving dual antiplatelet therapy for coronary artery disease, higher PTH levels are associated with an increased ADP-mediated platelet reactivity and suboptimal response to clopidogrel, especially for values above 96.7 pg/ml, while not influencing the effectiveness of ASA and ticagrelor.This article is protected by copyright. All rights reserved. |
| Ending Page | 215 |
| Starting Page | 209 |
| ISSN | 2573508X |
| e-ISSN | 17555922 |
| DOI | 10.1111/1755-5922.12188 |
| Journal | Cardiovascular Therapeutics |
| Issue Number | 4 |
| Volume Number | 34 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2016-07-06 |
| Access Restriction | Open |
| Subject Keyword | Journal: Cardiovascular Therapeutics Cardiology and Cardiovascular Diseases Parathyroid Hormone Platelet Aggregation Dual Antiplatelet Therapy Coronary Artery Disease Highâresidual Platelet Reactivity |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology Pharmacology (medical) Cardiology and Cardiovascular Medicine |
