title: High platelet reactivity affects the clinical outcomes of patients undergoing percutaneous coronary intervention.
abstract: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation.
  
  
  
  All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years. The secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all cause death, spontaneous myocardial infarction (MI), target vessel revascularization (TVR), and ischemic stroke.
  
  
  
  A total of 1331consecutive patients were enrolled at our center. There were 91 patients (6.8 %) identified with high platelet reactivity (HPR) on aspirin, and 437 patients (32.9 %) with HPR on clopidogrel. At 2-year follow-up, the incidence of stent thrombosis was significantly higher in patients with HPR on aspirin (9.9 % vs. 0.4 %, p < 0.001), and HPR on clopidogrel (3.0 % vs. 0.1 %, p < 0.001). There were increased MACCE in the HPR on aspirin group (16.5 % vs. 8.5 %, p = 0.021), mainly driven by the higher all cause death (7.7 % vs. 1.6 %, p = 0.002) and MI (9.9 % vs. 1.9 %, p < 0.001) in the HPR on aspirin group. Similarly, the rate of MACCE was higher in the HPR on clopidogrel group (12.4 % vs. 7.4 %, p = 0.004). No differences in all bleeding and hemorrhagic stroke were observed.
  
  
  
  The present study demonstrated that high platelet reactivity on both aspirin and clopidogrel were associated with incremental stent thrombosis following DESs implantation.
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.|Department of Cardiology, Nanjing Heart Center, Nanjing, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.|Department of Cardiology, Nanjing Heart Center, Nanjing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Ge
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.
authors.forename: Nai-Liang
authors.initials: NL
authors.lastname: Tian
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.
authors.forename: Song
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle road, 210006, Nanjing, China. chmengx@126.com.|Department of Cardiology, Nanjing Heart Center, Nanjing, China. chmengx@126.com.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Chen
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D001792:Blood Platelets / Q000502:physiology*; D000077144:Clopidogrel; D003324:Coronary Artery Disease / Q000097:blood / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010974:Platelet Aggregation / Q000502:physiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Drug eluting stent; High platelet reactivity; Platelet function test; Stent thrombosis