Differences in high on-treatment platelet reactivity between intracoronary and peripheral blood after dual anti-platelet agents in patients with coronary artery disease

Yu-Feng Hu; Tse-Min Lu; Cheng-Hsueh Wu; Yenn-Jiang Lin; Shih-Lin Chang; Li-Wei Lo; Ta-Chuan Tuan; Tze-Fan Chao; Fa-Po Chung; Jo-Nan Liao; Cheng-Hwai Tzeng; Shih-Ann Chen; Hsuan-Ming Tsao

doi:10.1160/TH13-01-0034

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2013; 110(01): 124-130
DOI: 10.1160/TH13-01-0034

Platelets and Blood Cells

Schattauer GmbH

Differences in high on-treatment platelet reactivity between intracoronary and peripheral blood after dual anti-platelet agents in patients with coronary artery disease

Authors

Yu-Feng Hu^*

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Tse-Min Lu^*

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Cheng-Hsueh Wu

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan

³Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Yenn-Jiang Lin

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Shih-Lin Chang

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Li-Wei Lo

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Ta-Chuan Tuan

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Tze-Fan Chao

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Fa-Po Chung

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Jo-Nan Liao

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Cheng-Hwai Tzeng

⁴Division of Hematology/Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Shih-Ann Chen

¹Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
Hsuan-Ming Tsao

²Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan

⁵Division of Cardiology, National Yang Ming University Hospital, I-Lan, Taiwan

Abstract

Summary

The differences of high on-treatment platelet reactivity (HPR) between the coronary arteries and peripheral veins might be associated with poor prediction of adverse cardiovascular events in patients with coronary artery diseases. HPR from the peripheral blood might not adequately reflect the platelet responses in the coronary artery. A total of 21 patients were recruited, and regional differences in HPR were compared between blood samples from the intra-coronary artery (IC), femoral artery (FA), and femoral vein (FV) by light aggregometry (agonists: arachidonic acid, LTA-AA; ADP, LTA-ADP), VerifyNow P2Y12 assays, and a platelet function analyser (PFA-100, collagen and epinephrine cartridge, PFA-CEPI). There were regional differences in the platelet reactivities observed by LTA-AA, VerifyNow P2Y12 assays, and PFACEPI. Platelets from the IC had higher platelet reactivities than those from the FV and FA by the VerifyNow P2Y12 assays but lower reactivities by LTA-AA and PFA-CEPI. HPR values from the blood in the FA were more similar to those from the IC than those from the FV by any test. The monocyte percentages were the only factors associated with differences in HPR between the FV and IC by the VerifyNow P2Y12 assays. Triglyceride levels were associated with the differences in HPR between the FV and IC by LTA-ADP. During the six-month follow-up period, two patients developed cardiovascular events and exhibited differences in HPR between different sites by VerifyNow P2Y12 assays. In conclusions, there were regional differences in HPR in patients with coronary artery diseases, which might prevent the adequate prediction of cardiovascular events.

Keywords

High on-treatment platelet reactivity - aspirin - clopidogrel - coronary artery disease

Full Text

References

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