The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventionsAhmet İlker Tekkeşin1, Adnan Kaya2, Yasin Çakıllı3, Ceyhan Türkkan1, Mert İlker Hayıroğlu1, Edibe Betül Borklu1, Koray Kalenderoğlu1, Ayca Gümüşdağ1, Özlem Yıldırımtürk1, Emrah Bozbeyoğlu1, Mustafa Adem Tatlısu4, Ahmet Taha Alper1
1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul-Turkey
2Department of Cardiology, Suruc State Hospital, Şanlıurfa-Turkey
3Department of Cardiology, Bağçılar Training Hospital, İstanbul-Turkey
4Department of Cardiology, Sivas Training Hospital, Sivas-Turkey
Objective: This study attempted to fill the gaps in evidence related to response to clopidogrel treatment in the Turkish population. The study aimed to determine the prevalence, associated risk factors, and clinical outcomes of high on-treatment platelet reactivity (HTPR) of clopidogrel in patients undergoing percutaneous coronary intervention (PCI) in a tertiary cardiovascular hospital in Turkey.Keywords: high on-treatment platelet reactivity, clopidogrel, percutaneous coronary intervention, prevalence, risk factors
Methods: In this prospective studied a total of 1.238 patients undergoing PCI were included in the present study. Blood samples were analyzed using a Multiplate analyzer. All patients were examined in the outpatient clinics at the end of the first and sixth months for recording drug therapy compliance and study endpoints.
Results: Among the study population, 324 (30.2%) patients were found to have HTPR (mean age 58.03±11.88 years, 71.7% men). The incidence of HTPR was higher amongst females than amongst males (38.3% vs. 27%, p=0.010). Hypertension and diabetes mellitus were more frequently observed in the HTPR group (57.7% vs. 48.7%, p=0.004; 35% vs. 29.1%, p=0.040, respectively). When the recorded data were analyzed using multinomial regression analysis, hypertension, hemoglobin level, platelet, lymphocyte, and eosinophil count were independently associated with HTPR.
Conclusion: On the basis of the results obtained from our study, we conclude that 30.2% of the Turkish population has HTPR. Our results also led us to believe that hypertension is an associated risk factor and decreased hemoglobin level as well as increased platelet counts are laboratory parameters that are strongly associated with the presence of HTPR. However, no differences were observed with regard to cardiovascular mortality and stent thrombosis. (Anatol J Cardiol 2016; 16: 967-73)
Ahmet İlker Tekkeşin, Adnan Kaya, Yasin Çakıllı, Ceyhan Türkkan, Mert İlker Hayıroğlu, Edibe Betül Borklu, Koray Kalenderoğlu, Ayca Gümüşdağ, Özlem Yıldırımtürk, Emrah Bozbeyoğlu, Mustafa Adem Tatlısu, Ahmet Taha Alper. The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions. Anatol J Cardiol. 2016; 16(12): 967-973
Corresponding Author: Adnan Kaya, Türkiye