Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy
Introduction The optimal duration of dual anti-platelet therapy (DAPT) following percutaneous coronary intervention (PCI) is still a matter of debate. Biomarkers may help to identify patients who will benefit from extended DAPT. The aim of the study was to test the interaction between lipid paramete...
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2018
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oai:doaj.org-article:456b7b6919d84e3b8d6ac64cf3909fbe2021-12-02T19:15:49ZIncreased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy1734-19221896-915110.5114/aoms.2018.81035https://doaj.org/article/456b7b6919d84e3b8d6ac64cf3909fbe2018-12-01T00:00:00Zhttps://www.archivesofmedicalscience.com/Increased-platelet-reactivity-in-dyslipidemic-patients-with-coronary-artery-disease,76890,0,2.htmlhttps://doaj.org/toc/1734-1922https://doaj.org/toc/1896-9151Introduction The optimal duration of dual anti-platelet therapy (DAPT) following percutaneous coronary intervention (PCI) is still a matter of debate. Biomarkers may help to identify patients who will benefit from extended DAPT. The aim of the study was to test the interaction between lipid parameters and platelet function in patients with coronary artery disease (CAD) on DAPT. Material and methods Overall, 58 patients on DAPT were prospectively included following PCI in stable CAD. Platelet markers, i.e. mean platelet volume (MPV), platelet distribution width (PDW), fraction of reticulated thrombocytes (RT) and ADP-induced multiple electrode aggregometry (MEA), as well as serum lipids, i.e. high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG) and remnant cholesterol (RC), were assessed after intake of a maintenance dose of ASA and P2Y12 inhibitor. Results A significant inverse correlation was found for HDL-C levels and markers of platelet activation: MPV (r = –0.351, p = 0.009), PDW (r = –0.391, p = 0.003), fraction of RT (r = –0.402, p = 0.003) and ADP-induced MEA (r = –0.345, p = 0.011). Only a weak or no association was found between other lipid parameters and platelet markers. After multivariable adjustment, HDL-C levels served as a strong and significant predictor of MPV (95% CI: –0.039 to –0.009; p = 0.002), PDW (95% CI: –0.094 to –0.034; p < 0.0001), RT (95% CI: –0.107 to –0.031; p = 0.001) and MEA (95% CI: –0.540 to –0.170; p < 0.0001), while TG, LDL-C, RC and TC were not significantly associated with platelet function. Conclusions Within lipid parameters, only HDL-C levels are strongly associated with markers of platelet activation in CAD patients on DAPT. Accordingly, detection of dyslipidemia might indicate the need for prolongation of DAPT.Bernhard JägerEditha PiackovaPaul Michael HallerTijana AndricBeatrice KahlGünther ChristAlexander GeppertJohann WojtaKurt HuberTermedia Publishing Housearticlediabetes mellitushba1cdyslipidemiaplatelet activationhdl cholesterolcholesterol fractionsp2y12 inhibitordapt scoreplatelet functionhigh-density lipoprotein cholesterolMedicineRENArchives of Medical Science, Vol 15, Iss 1, Pp 65-71 (2018) |
| institution |
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| collection |
DOAJ |
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EN |
| topic |
diabetes mellitus hba1c dyslipidemia platelet activation hdl cholesterol cholesterol fractions p2y12 inhibitor dapt score platelet function high-density lipoprotein cholesterol Medicine R |
| spellingShingle |
diabetes mellitus hba1c dyslipidemia platelet activation hdl cholesterol cholesterol fractions p2y12 inhibitor dapt score platelet function high-density lipoprotein cholesterol Medicine R Bernhard Jäger Editha Piackova Paul Michael Haller Tijana Andric Beatrice Kahl Günther Christ Alexander Geppert Johann Wojta Kurt Huber Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| description |
Introduction
The optimal duration of dual anti-platelet therapy (DAPT) following percutaneous coronary intervention (PCI) is still a matter of debate. Biomarkers may help to identify patients who will benefit from extended DAPT. The aim of the study was to test the interaction between lipid parameters and platelet function in patients with coronary artery disease (CAD) on DAPT.
Material and methods
Overall, 58 patients on DAPT were prospectively included following PCI in stable CAD. Platelet markers, i.e. mean platelet volume (MPV), platelet distribution width (PDW), fraction of reticulated thrombocytes (RT) and ADP-induced multiple electrode aggregometry (MEA), as well as serum lipids, i.e. high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG) and remnant cholesterol (RC), were assessed after intake of a maintenance dose of ASA and P2Y12 inhibitor.
Results
A significant inverse correlation was found for HDL-C levels and markers of platelet activation: MPV (r = –0.351, p = 0.009), PDW (r = –0.391, p = 0.003), fraction of RT (r = –0.402, p = 0.003) and ADP-induced MEA (r = –0.345, p = 0.011). Only a weak or no association was found between other lipid parameters and platelet markers. After multivariable adjustment, HDL-C levels served as a strong and significant predictor of MPV (95% CI: –0.039 to –0.009; p = 0.002), PDW (95% CI: –0.094 to –0.034; p < 0.0001), RT (95% CI: –0.107 to –0.031; p = 0.001) and MEA (95% CI: –0.540 to –0.170; p < 0.0001), while TG, LDL-C, RC and TC were not significantly associated with platelet function.
Conclusions
Within lipid parameters, only HDL-C levels are strongly associated with markers of platelet activation in CAD patients on DAPT. Accordingly, detection of dyslipidemia might indicate the need for prolongation of DAPT. |
| format |
article |
| author |
Bernhard Jäger Editha Piackova Paul Michael Haller Tijana Andric Beatrice Kahl Günther Christ Alexander Geppert Johann Wojta Kurt Huber |
| author_facet |
Bernhard Jäger Editha Piackova Paul Michael Haller Tijana Andric Beatrice Kahl Günther Christ Alexander Geppert Johann Wojta Kurt Huber |
| author_sort |
Bernhard Jäger |
| title |
Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| title_short |
Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| title_full |
Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| title_fullStr |
Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| title_full_unstemmed |
Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| title_sort |
increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy |
| publisher |
Termedia Publishing House |
| publishDate |
2018 |
| url |
https://doaj.org/article/456b7b6919d84e3b8d6ac64cf3909fbe |
| work_keys_str_mv |
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