title: Platelet reactivity over time in coronary artery disease patients treated with a bioabsorbable everolimus-eluting scaffold.
abstract: Everolimus-eluting bioabsorbable scaffolds (BVSs) have exhibited similar long-term clinical outcomes compared to its everolimus-eluting metallic counterparts. However, reports from earlier studies have shown a signal for an increased rate of stent thrombosis. The aim of the current investigation is to describe the platelet reactivity profiles over time in patients treated with everolimus-eluting BVS in comparison to everolimus-eluting metallic stents. This is a pilot study in which patients on aspirin and clopidogrel with at least 1 everolimus-eluting BVS were included (n = 24). Patients with at least 1 everolimus-eluting metallic stent implanted were included as control group (n = 25). Blood samples were taken at time of discharge and at 3- and 6-month follow-up. Platelet function tests included VerifyNow (VN-P2Y12), multiplate aggregometry (MEA), and light transmission aggregometry (LTA). There was no difference in platelet reactivity at discharge, 3- and 6-month visits (unadjusted p = 0.733 and p = 0.582; p = 0.432 and p = 0.899 after adjusting for discharge value platelet reactivity0, respectively) using VN-P2Y12. Similar findings were observed with LTA. However, patients with BVS showed significantly higher platelet reactivity than patients with metallic stents at 3 and 6 months in the crude analysis (p = 0.003) and after adjusting for discharge value (p = 0.013) measured with ADP-MEA. There were no differences in platelet reactivity mediated by the T × A2pathway between both groups. Finally, there is no statistical difference in high on-clopidogrel platelet reactivity (HPR) rate between both groups. The results of this pilot study suggest that BVS might have different platelet reactivity profiles, and warrants further investigation in dedicated clinical studies.
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tello-Montoliu
authors.affiliation: b Hematology and Oncology Department , Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: José
authors.initials: J
authors.lastname: Rivera
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Hernández-Romero
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Silvente
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Jover
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Quintana
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Esteban
authors.initials: E
authors.lastname: Orenes-Piñero
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: José
authors.initials: J
authors.lastname: Hurtado
authors.affiliation: c Heart Diseases Institute, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat , Barcelona , Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ferreiro
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Marín
authors.affiliation: a Cardiology Department , Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain.
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés
mesh_terms: D020341:Absorbable Implants; D000244:Adenosine Diphosphate / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D040761:Biomimetic Materials; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010865:Pilot Projects; D015539:Platelet Activation; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors; D010979:Platelet Function Tests; D011446:Prospective Studies; D018048:Receptors, Purinergic P2 / Q000378:metabolism; D044244:Receptors, Thromboxane A2, Prostaglandin H2 / Q000378:metabolism; D015398:Signal Transduction; D054457:Tissue Scaffolds; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors; D018048:Receptors, Purinergic P2; D044244:Receptors, Thromboxane A2, Prostaglandin H2; D000244:Adenosine Diphosphate; D000068338:Everolimus
keywords: Bioabsorbable scaffold; coronary disease; platelet aggregation; revascularization