title: Relation between the Change in Mean Platelet Volume and Clopidogrel Resistance in Patients Undergoing Percutaneous Coronary Intervention.
abstract: We aimed to determine the association between the change in mean platelet volume (MPV) over time and aspirin/ clopidogrel resistance in patients undergoing percutaneous coronary intervention (PCI). The MPV and platelet function were analysed in 302 patients who underwent PCI. MPV changes were associated with increased aspirin reaction units (ARU, r = 0.114; P = 0.047), increased P2Y12 reaction units (PRU, r = 0.193; P = 0.001), and decreased P2Y12% inhibition (PI%, r = - 0.273; P < 0.001). The group with increasing MPV values showed significantly higher PRU values and lower PI% compared with the group with decreasing MPV values (222.5 ± 73.9 vs. 195.6 ± 63.7 PRU, P = 0.001; 24.1 ± 21.0 vs. 32.8 ± 18.5 PI%, P < 0.001, respectively). The clopidogrel resistant group (≥235 PRU or ≤15% of PI%) showed a significantly higher positive change in MPV (ΔMPV) values than the clopidogrel responder group (0.53 ± 0.78 vs. 0.13 ± 0.69 fL, P < 0.001). When the ΔMPV cut-off level was set at 0.20 fL using the receiver operating characteristic curve, the sensitivity and specificity for differentiating between the clopidogrel resistant and responder groups were 72.6% and 59.3%, respectively. After adjusting for traditional risk factors, the odds ratio in the clopidogrel resistant group with ΔMPV ≥0.2 fL was 4.10 (95% confidence interval; 1.84-9.17). In conclusion, ΔMPV was associated with PRU and PI%; a positive ΔMPV was an independent predictive marker for clopidogrel resistance after PCI.
authors.forename: Young-Youp
authors.initials: YY
authors.lastname: Koh
authors.forename: Hyung Ho
authors.initials: HH
authors.lastname: Kim
authors.affiliation: College of Medicine, Chosun University, 375 Seo-suk dong, Dong-Gu, Gwangju 501-759, Republic of Korea. dhchoi@chosun.ac.kr.
authors.forename: Dong-Hyun
authors.initials: DH
authors.lastname: Choi
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Lee
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Ki
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kang
authors.forename: Geon
authors.initials: G
authors.lastname: Park
authors.forename: Joong-Wha
authors.initials: JW
authors.lastname: Chung
authors.forename: Kyong-Sig
authors.initials: KS
authors.lastname: Chang
authors.forename: Soon-Pyo
authors.initials: SP
authors.lastname: Hong
mesh_terms: D000368:Aged; D001241:Aspirin / Q000008:administration & dosage* / Q000494:pharmacology; D000077144:Clopidogrel; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin