Clinical outcomes of high on-treatment platelet reactivity in Koreans receiving elective percutaneous coronary intervention (from results of the CROSS VERIFY study)

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Abstract

Platelet reactivity after clopidogrel therapy varies among patients. Whether clopidogrel response variability can predict clinical outcomes has not been verified in Asians. A prospective cohort was analyzed to evaluate clinical impact of clopidogrel response variability in patients who underwent elective percutaneous coronary intervention (PCI). A total of 809 consecutive patients receiving clopidogrel after elective PCI were followed for 1 year. On-treatment platelet reactivity (OPR) after clopidogrel therapy was measured with a point-of-care test, the VerifyNow P2Y12 assay. The primary end point was the composite of cardiac death and nonfatal myocardial infarction (MI) at 1 year. In this exclusively Korean cohort, the median OPR was 236 P2Y12 reactivity units. Using the definition of OPR <235 P2Y12 reactivity units as high OPR (HOPR), 50.3% of the cohort showed HOPR. The group with HOPR had significantly higher rates of cardiac death and spontaneous MI (2.5% vs 0.5%, p = 0.022) than the group without HOPR. Multivariate-adjusted analysis showed that HOPR was an independent predictor of the composite of cardiac death and nonfatal MI. The difference in major adverse cardiac events between the groups with and without HOPR was more profound in those without major cardiovascular disease, such as hypertension, diabetes mellitus, or dyslipidemia. In conclusion, HOPR to clopidogrel was significantly associated with cardiac death and spontaneous MI after elective PCI, suggesting that clopidogrel response variability may be a significant risk factor of hard end points in Koreans.

Original languageEnglish
Pages (from-to)1556-1563
Number of pages8
JournalAmerican Journal of Cardiology
Volume108
Issue number11
DOIs
StatePublished - 1 Dec 2011

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clopidogrel
Percutaneous Coronary Intervention
Blood Platelets
Myocardial Infarction
Therapeutics
Point-of-Care Systems
Dyslipidemias
Diabetes Mellitus

Cite this

@article{a35c32bdcab54c799c3f37c927994c46,
title = "Clinical outcomes of high on-treatment platelet reactivity in Koreans receiving elective percutaneous coronary intervention (from results of the CROSS VERIFY study)",
abstract = "Platelet reactivity after clopidogrel therapy varies among patients. Whether clopidogrel response variability can predict clinical outcomes has not been verified in Asians. A prospective cohort was analyzed to evaluate clinical impact of clopidogrel response variability in patients who underwent elective percutaneous coronary intervention (PCI). A total of 809 consecutive patients receiving clopidogrel after elective PCI were followed for 1 year. On-treatment platelet reactivity (OPR) after clopidogrel therapy was measured with a point-of-care test, the VerifyNow P2Y12 assay. The primary end point was the composite of cardiac death and nonfatal myocardial infarction (MI) at 1 year. In this exclusively Korean cohort, the median OPR was 236 P2Y12 reactivity units. Using the definition of OPR <235 P2Y12 reactivity units as high OPR (HOPR), 50.3{\%} of the cohort showed HOPR. The group with HOPR had significantly higher rates of cardiac death and spontaneous MI (2.5{\%} vs 0.5{\%}, p = 0.022) than the group without HOPR. Multivariate-adjusted analysis showed that HOPR was an independent predictor of the composite of cardiac death and nonfatal MI. The difference in major adverse cardiac events between the groups with and without HOPR was more profound in those without major cardiovascular disease, such as hypertension, diabetes mellitus, or dyslipidemia. In conclusion, HOPR to clopidogrel was significantly associated with cardiac death and spontaneous MI after elective PCI, suggesting that clopidogrel response variability may be a significant risk factor of hard end points in Koreans.",
author = "Park, {Kyung Woo} and Jeon, {Ki Hyun} and Kang, {Si Hyuk} and Il-Young Oh and Cho, {Hyun Jai} and Lee, {Hae Young} and Kang, {Hyun Jae} and Park, {Sue Kyung} and Bonkwon Koo and Oh, {Byung Hee} and Park, {Young Bae} and Hyo-Soo Kim",
year = "2011",
month = "12",
day = "1",
doi = "10.1016/j.amjcard.2011.07.012",
language = "English",
volume = "108",
pages = "1556--1563",
journal = "American Journal of Cardiology",
issn = "0002-9149",
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TY - JOUR

T1 - Clinical outcomes of high on-treatment platelet reactivity in Koreans receiving elective percutaneous coronary intervention (from results of the CROSS VERIFY study)

AU - Park, Kyung Woo

AU - Jeon, Ki Hyun

AU - Kang, Si Hyuk

AU - Oh, Il-Young

AU - Cho, Hyun Jai

AU - Lee, Hae Young

AU - Kang, Hyun Jae

AU - Park, Sue Kyung

AU - Koo, Bonkwon

AU - Oh, Byung Hee

AU - Park, Young Bae

AU - Kim, Hyo-Soo

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Platelet reactivity after clopidogrel therapy varies among patients. Whether clopidogrel response variability can predict clinical outcomes has not been verified in Asians. A prospective cohort was analyzed to evaluate clinical impact of clopidogrel response variability in patients who underwent elective percutaneous coronary intervention (PCI). A total of 809 consecutive patients receiving clopidogrel after elective PCI were followed for 1 year. On-treatment platelet reactivity (OPR) after clopidogrel therapy was measured with a point-of-care test, the VerifyNow P2Y12 assay. The primary end point was the composite of cardiac death and nonfatal myocardial infarction (MI) at 1 year. In this exclusively Korean cohort, the median OPR was 236 P2Y12 reactivity units. Using the definition of OPR <235 P2Y12 reactivity units as high OPR (HOPR), 50.3% of the cohort showed HOPR. The group with HOPR had significantly higher rates of cardiac death and spontaneous MI (2.5% vs 0.5%, p = 0.022) than the group without HOPR. Multivariate-adjusted analysis showed that HOPR was an independent predictor of the composite of cardiac death and nonfatal MI. The difference in major adverse cardiac events between the groups with and without HOPR was more profound in those without major cardiovascular disease, such as hypertension, diabetes mellitus, or dyslipidemia. In conclusion, HOPR to clopidogrel was significantly associated with cardiac death and spontaneous MI after elective PCI, suggesting that clopidogrel response variability may be a significant risk factor of hard end points in Koreans.

AB - Platelet reactivity after clopidogrel therapy varies among patients. Whether clopidogrel response variability can predict clinical outcomes has not been verified in Asians. A prospective cohort was analyzed to evaluate clinical impact of clopidogrel response variability in patients who underwent elective percutaneous coronary intervention (PCI). A total of 809 consecutive patients receiving clopidogrel after elective PCI were followed for 1 year. On-treatment platelet reactivity (OPR) after clopidogrel therapy was measured with a point-of-care test, the VerifyNow P2Y12 assay. The primary end point was the composite of cardiac death and nonfatal myocardial infarction (MI) at 1 year. In this exclusively Korean cohort, the median OPR was 236 P2Y12 reactivity units. Using the definition of OPR <235 P2Y12 reactivity units as high OPR (HOPR), 50.3% of the cohort showed HOPR. The group with HOPR had significantly higher rates of cardiac death and spontaneous MI (2.5% vs 0.5%, p = 0.022) than the group without HOPR. Multivariate-adjusted analysis showed that HOPR was an independent predictor of the composite of cardiac death and nonfatal MI. The difference in major adverse cardiac events between the groups with and without HOPR was more profound in those without major cardiovascular disease, such as hypertension, diabetes mellitus, or dyslipidemia. In conclusion, HOPR to clopidogrel was significantly associated with cardiac death and spontaneous MI after elective PCI, suggesting that clopidogrel response variability may be a significant risk factor of hard end points in Koreans.

UR - http://www.scopus.com/inward/record.url?scp=80955144204&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2011.07.012

DO - 10.1016/j.amjcard.2011.07.012

M3 - Article

C2 - 21880289

AN - SCOPUS:80955144204

VL - 108

SP - 1556

EP - 1563

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 11

ER -