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Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry.

Publication ,  Journal Article
Baber, U; Mehran, R; Kirtane, AJ; Gurbel, PA; Christodoulidis, G; Maehara, A; Witzenbichler, B; Weisz, G; Rinaldi, MJ; Metzger, DC; Henry, TD ...
Published in: Circ Cardiovasc Interv
June 2015

BACKGROUND: Chronic kidney disease (CKD) is associated with increased rates of adverse events after percutaneous coronary intervention. We sought to determine the impact of CKD on platelet reactivity in clopidogrel-treated patients and whether high platelet reactivity (HPR) confers a similar or differential risk for adverse events among patients with CKD and non-CKD. METHODS AND RESULTS: We performed a post hoc analysis of the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) registry, which included 8582 patients undergoing percutaneous coronary intervention with drug-eluting stents and platelet function testing using the VerifyNow assay. We compared HPR and its impact on ischemic and bleeding events >2 years among patients with CKD and non-CKD. Patients with CKD (n=1367) were older, more often female, diabetic, and had lower ejection fraction compared with their non-CKD counterparts (n=7043). Although HPR prevalence increased with worsening renal function in unadjusted analyses, these associations were no longer present after adjustment. Major adverse cardiac event rates at 2 years among those without CKD or HPR, HPR alone, CKD alone, and both CKD and HPR were 9.0%, 11.2%, 13.3%, and 17.5%, respectively (P<0.001). Associations between HPR and adverse events were uniform across CKD strata without evidence of interaction. CONCLUSIONS: HPR is more common among those with versus without CKD, an association that is attributable to confounding risk factors that are more prevalent in CKD. The impact of HPR on ischemic and bleeding events is similar irrespective of CKD status. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00638794.

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Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

June 2015

Volume

8

Issue

6

Start / End Page

e001683

Location

United States

Related Subject Headings

  • Renal Insufficiency, Chronic
  • Registries
  • Prospective Studies
  • Platelet Function Tests
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Male
  • Ischemia
  • Humans
 

Citation

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Baber, U., Mehran, R., Kirtane, A. J., Gurbel, P. A., Christodoulidis, G., Maehara, A., … Stone, G. W. (2015). Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry. Circ Cardiovasc Interv, 8(6), e001683. https://doi.org/10.1161/CIRCINTERVENTIONS.115.001683
Baber, Usman, Roxana Mehran, Ajay J. Kirtane, Paul A. Gurbel, Georgios Christodoulidis, Akiko Maehara, Bernhard Witzenbichler, et al. “Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry.Circ Cardiovasc Interv 8, no. 6 (June 2015): e001683. https://doi.org/10.1161/CIRCINTERVENTIONS.115.001683.
Baber U, Mehran R, Kirtane AJ, Gurbel PA, Christodoulidis G, Maehara A, et al. Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry. Circ Cardiovasc Interv. 2015 Jun;8(6):e001683.
Baber, Usman, et al. “Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry.Circ Cardiovasc Interv, vol. 8, no. 6, June 2015, p. e001683. Pubmed, doi:10.1161/CIRCINTERVENTIONS.115.001683.
Baber U, Mehran R, Kirtane AJ, Gurbel PA, Christodoulidis G, Maehara A, Witzenbichler B, Weisz G, Rinaldi MJ, Metzger DC, Henry TD, Cox DA, Duffy PL, Mazzaferri EL, Xu K, Parise H, Brodie BR, Stuckey TD, Stone GW. Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry. Circ Cardiovasc Interv. 2015 Jun;8(6):e001683.

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

June 2015

Volume

8

Issue

6

Start / End Page

e001683

Location

United States

Related Subject Headings

  • Renal Insufficiency, Chronic
  • Registries
  • Prospective Studies
  • Platelet Function Tests
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Male
  • Ischemia
  • Humans