Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons

Impact of high platelet reactivity

Adrienn Tornyos, Dániel Aradi, I. Horváth, Attila Kónyi, Balázs Magyari, Tünde Pintér, András Vorobcsuk, Dániel Tornyos, A. Komócsi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The impact of high platelet reactivity (HPR) on clinical outcomes after elective percutaneous coronary interventions (PCI) with drug-eluting balloons (DEB) due to in-stent restenosis (ISR) is unknown. Objective: We sought to evaluate the prognostic importance of HPR together with conventional risk factors in patients treated with DEB. Methods: Patients treated with DEB due to ISR were enrolled in a single-centre, prospective registry between October 2009 and March 2015. Only patients with recent myocardial infarction (MI) received prasugrel, others were treated with clopidogrel. HPR was defined as an ADP-test >46U with the Multiplate assay and no adjustments were done based on results. The primary endpoint of the study was a composite of cardiovascular mortality, MI, any revascularization or stroke during one-year follow-up. Results: 194 stable angina patients were recruited of whom 90% were treated with clopidogrel. Clinical characteristics and procedural data were available for all patients; while platelet function testing was performed in 152 subjects of whom 32 (21%) had HPR. Patients with HPR had a higher risk for the primary endpoint (HR: 2.45; CI: 1.01–5.92; p = 0.03). The difference was primarily driven by a higher risk for revascularization and MI. According to the multivariate analysis, HPR remained a significant, independent predictor of the primary endpoint (HR: 2.88; CI: 1.02–8.14; p = 0.04), while total DEB length and statin treatment were other independent correlates of the primary outcome. Conclusion: HPR was found to be an independent predictor of repeat revascularization and MI among elective patients with ISR undergoing PCI with DEB.

Original languageEnglish
Article numbere0188493
JournalPLoS One
Volume12
Issue number12
DOIs
Publication statusPublished - Dec 1 2017

Fingerprint

Stents
Balloons
Platelets
Blood Platelets
myocardial infarction
drugs
clopidogrel
Pharmaceutical Preparations
endpoints
Myocardial Infarction
Percutaneous Coronary Intervention
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Stable Angina
stroke
multivariate analysis
Adenosine Diphosphate
risk factors
Registries
Assays
testing

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons : Impact of high platelet reactivity. / Tornyos, Adrienn; Aradi, Dániel; Horváth, I.; Kónyi, Attila; Magyari, Balázs; Pintér, Tünde; Vorobcsuk, András; Tornyos, Dániel; Komócsi, A.

In: PLoS One, Vol. 12, No. 12, e0188493, 01.12.2017.

Research output: Contribution to journalArticle

Tornyos, Adrienn ; Aradi, Dániel ; Horváth, I. ; Kónyi, Attila ; Magyari, Balázs ; Pintér, Tünde ; Vorobcsuk, András ; Tornyos, Dániel ; Komócsi, A. / Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons : Impact of high platelet reactivity. In: PLoS One. 2017 ; Vol. 12, No. 12.
@article{cef4f162e98d422cae74cf75bdf35b4f,
title = "Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons: Impact of high platelet reactivity",
abstract = "Background: The impact of high platelet reactivity (HPR) on clinical outcomes after elective percutaneous coronary interventions (PCI) with drug-eluting balloons (DEB) due to in-stent restenosis (ISR) is unknown. Objective: We sought to evaluate the prognostic importance of HPR together with conventional risk factors in patients treated with DEB. Methods: Patients treated with DEB due to ISR were enrolled in a single-centre, prospective registry between October 2009 and March 2015. Only patients with recent myocardial infarction (MI) received prasugrel, others were treated with clopidogrel. HPR was defined as an ADP-test >46U with the Multiplate assay and no adjustments were done based on results. The primary endpoint of the study was a composite of cardiovascular mortality, MI, any revascularization or stroke during one-year follow-up. Results: 194 stable angina patients were recruited of whom 90{\%} were treated with clopidogrel. Clinical characteristics and procedural data were available for all patients; while platelet function testing was performed in 152 subjects of whom 32 (21{\%}) had HPR. Patients with HPR had a higher risk for the primary endpoint (HR: 2.45; CI: 1.01–5.92; p = 0.03). The difference was primarily driven by a higher risk for revascularization and MI. According to the multivariate analysis, HPR remained a significant, independent predictor of the primary endpoint (HR: 2.88; CI: 1.02–8.14; p = 0.04), while total DEB length and statin treatment were other independent correlates of the primary outcome. Conclusion: HPR was found to be an independent predictor of repeat revascularization and MI among elective patients with ISR undergoing PCI with DEB.",
author = "Adrienn Tornyos and D{\'a}niel Aradi and I. Horv{\'a}th and Attila K{\'o}nyi and Bal{\'a}zs Magyari and T{\"u}nde Pint{\'e}r and Andr{\'a}s Vorobcsuk and D{\'a}niel Tornyos and A. Kom{\'o}csi",
year = "2017",
month = "12",
day = "1",
doi = "10.1371/journal.pone.0188493",
language = "English",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

TY - JOUR

T1 - Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons

T2 - Impact of high platelet reactivity

AU - Tornyos, Adrienn

AU - Aradi, Dániel

AU - Horváth, I.

AU - Kónyi, Attila

AU - Magyari, Balázs

AU - Pintér, Tünde

AU - Vorobcsuk, András

AU - Tornyos, Dániel

AU - Komócsi, A.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background: The impact of high platelet reactivity (HPR) on clinical outcomes after elective percutaneous coronary interventions (PCI) with drug-eluting balloons (DEB) due to in-stent restenosis (ISR) is unknown. Objective: We sought to evaluate the prognostic importance of HPR together with conventional risk factors in patients treated with DEB. Methods: Patients treated with DEB due to ISR were enrolled in a single-centre, prospective registry between October 2009 and March 2015. Only patients with recent myocardial infarction (MI) received prasugrel, others were treated with clopidogrel. HPR was defined as an ADP-test >46U with the Multiplate assay and no adjustments were done based on results. The primary endpoint of the study was a composite of cardiovascular mortality, MI, any revascularization or stroke during one-year follow-up. Results: 194 stable angina patients were recruited of whom 90% were treated with clopidogrel. Clinical characteristics and procedural data were available for all patients; while platelet function testing was performed in 152 subjects of whom 32 (21%) had HPR. Patients with HPR had a higher risk for the primary endpoint (HR: 2.45; CI: 1.01–5.92; p = 0.03). The difference was primarily driven by a higher risk for revascularization and MI. According to the multivariate analysis, HPR remained a significant, independent predictor of the primary endpoint (HR: 2.88; CI: 1.02–8.14; p = 0.04), while total DEB length and statin treatment were other independent correlates of the primary outcome. Conclusion: HPR was found to be an independent predictor of repeat revascularization and MI among elective patients with ISR undergoing PCI with DEB.

AB - Background: The impact of high platelet reactivity (HPR) on clinical outcomes after elective percutaneous coronary interventions (PCI) with drug-eluting balloons (DEB) due to in-stent restenosis (ISR) is unknown. Objective: We sought to evaluate the prognostic importance of HPR together with conventional risk factors in patients treated with DEB. Methods: Patients treated with DEB due to ISR were enrolled in a single-centre, prospective registry between October 2009 and March 2015. Only patients with recent myocardial infarction (MI) received prasugrel, others were treated with clopidogrel. HPR was defined as an ADP-test >46U with the Multiplate assay and no adjustments were done based on results. The primary endpoint of the study was a composite of cardiovascular mortality, MI, any revascularization or stroke during one-year follow-up. Results: 194 stable angina patients were recruited of whom 90% were treated with clopidogrel. Clinical characteristics and procedural data were available for all patients; while platelet function testing was performed in 152 subjects of whom 32 (21%) had HPR. Patients with HPR had a higher risk for the primary endpoint (HR: 2.45; CI: 1.01–5.92; p = 0.03). The difference was primarily driven by a higher risk for revascularization and MI. According to the multivariate analysis, HPR remained a significant, independent predictor of the primary endpoint (HR: 2.88; CI: 1.02–8.14; p = 0.04), while total DEB length and statin treatment were other independent correlates of the primary outcome. Conclusion: HPR was found to be an independent predictor of repeat revascularization and MI among elective patients with ISR undergoing PCI with DEB.

UR - http://www.scopus.com/inward/record.url?scp=85037641288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037641288&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0188493

DO - 10.1371/journal.pone.0188493

M3 - Article

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e0188493

ER -