title: Low mean corpuscular hemoglobin level is a predictor of discontinuation of antiplatelet therapy in patients with acute coronary syndrome.
abstract: OBJECTIVE
  Premature discontinuation of antiplatelet therapy (APT) increases the risk of thrombosis in patients who have undergone placement of a drug-eluting stent for acute coronary syndrome (ACS). The goal of the present study was to identify predictors of patients who would prematurely discontinue APT following stent implantation.
  
  
  METHODS
  One-hundred and sixty-one ACS patients who underwent percutaneous coronary intervention in our institution between November 2004 and September 2008 were enrolled in this study.
  
  
  RESULTS
  Over the 12-month follow-up period, 18 patients (11.2%) discontinued APT. Among baseline demographic and laboratory variables, multivariate analysis revealed that mean corpuscular hemoglobin (MCH) level was an independent risk factor for APT discontinuation (OR: 0.738, p=0.017). Kaplan-Meier survival analysis showed that the incidence of APT discontinuation was significantly higher in patients with low MCH (<30.0 pg) than in patients with high MCH (≥30.0 pg) (p=0.0006).
  
  
  CONCLUSIONS
  Low baseline MCH level was a predictor of APT discontinuation in ACS patients. Thus, careful consideration should be made before employing a drug-eluting stent in patients with low MCH levels.
authors.affiliation: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Ishida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.forename: Megumi
authors.initials: M
authors.lastname: Okawa
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000188:drug therapy* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004909:Erythrocyte Indices; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin