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Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study.

Publication ,  Journal Article
Kwon, TJ; Tantry, US; Park, Y; Choi, Y-M; Ahn, J-H; Kim, KH; Koh, J-S; Park, J-R; Hwang, S-J; Kwak, CH; Hwang, J-Y; Gurbel, PA; Smith, SC; Jeong, Y-H
Published in: Thromb Haemost
May 2, 2016

An increasing body of data suggests that East Asian patients have differing risk profiles for both thrombophilia and bleeding compared with Western population. This study was designed to evaluate the relationship of bleeding to platelet function in East Asians undergoing percutaneous coronary intervention (PCI). Patients who had undergone uneventful PCI (n= 301) were prospectively enrolled and bleeding events were evaluated during dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. Platelet function was measured during hospitalisation and at 30-day follow-up by light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) assay. During 30-day follow-up, 29.2 % of patients (n= 88) experienced post-discharge Bleeding Academic Research Consortium (BARC) complications (24.6 % and 7.0 % of BARC type 1 and 2, respectively). Patients presenting with acute myocardial infarction had fewer episodes of type 1 BARC bleeding (odds ratio: 0.41; 95 % confidence interval: 0.22 to 0.76; p= 0.005). The cut-off of low platelet reactivity (LPR) (20 µM ADP-induced platelet aggregation ≤ 46.1 %; platelet reactivity index ≤ 45.1 %) was the independent determinant of type 2 BARC bleeding (odds ratio: 3.55 and 4.44; p= 0.009 and 0.002, respectively). The first 30-day BARC bleeding episodes were associated with an increased rate of subsequent premature DAPT discontinuation during one-year follow-up (4.7 % vs 11.4 %; odds ratio: 2.60; 95 % confidence interval: 1.04 to 6.50; p= 0.035). In conclusion, among East Asians, mild bleeding episodes are common early after PCI and are associated with premature DAPT discontinuation. Type 2 BARC bleeding episodes are associated with LPR cut-offs measured at 30 days post-discharge.

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Published In

Thromb Haemost

DOI

EISSN

2567-689X

Publication Date

May 2, 2016

Volume

115

Issue

5

Start / End Page

979 / 992

Location

Germany

Related Subject Headings

  • Time Factors
  • Ticlopidine
  • Purinergic P2Y Receptor Antagonists
  • Prospective Studies
  • Polymorphism, Single Nucleotide
  • Platelet Function Tests
  • Platelet Aggregation Inhibitors
  • Platelet Activation
  • Phosphoproteins
  • Percutaneous Coronary Intervention
 

Citation

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Kwon, T. J., Tantry, U. S., Park, Y., Choi, Y.-M., Ahn, J.-H., Kim, K. H., … Jeong, Y.-H. (2016). Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study. Thromb Haemost, 115(5), 979–992. https://doi.org/10.1160/TH15-05-0366
Kwon, Tae Jung, Udaya S. Tantry, Yongwhi Park, Young-Min Choi, Jong-Hwa Ahn, Kye Hwan Kim, Jin-Sin Koh, et al. “Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study.Thromb Haemost 115, no. 5 (May 2, 2016): 979–92. https://doi.org/10.1160/TH15-05-0366.
Kwon TJ, Tantry US, Park Y, Choi Y-M, Ahn J-H, Kim KH, et al. Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study. Thromb Haemost. 2016 May 2;115(5):979–92.
Kwon, Tae Jung, et al. “Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study.Thromb Haemost, vol. 115, no. 5, May 2016, pp. 979–92. Pubmed, doi:10.1160/TH15-05-0366.
Kwon TJ, Tantry US, Park Y, Choi Y-M, Ahn J-H, Kim KH, Koh J-S, Park J-R, Hwang S-J, Kwak CH, Hwang J-Y, Gurbel PA, Smith SC, Jeong Y-H. Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study. Thromb Haemost. 2016 May 2;115(5):979–992.
Journal cover image

Published In

Thromb Haemost

DOI

EISSN

2567-689X

Publication Date

May 2, 2016

Volume

115

Issue

5

Start / End Page

979 / 992

Location

Germany

Related Subject Headings

  • Time Factors
  • Ticlopidine
  • Purinergic P2Y Receptor Antagonists
  • Prospective Studies
  • Polymorphism, Single Nucleotide
  • Platelet Function Tests
  • Platelet Aggregation Inhibitors
  • Platelet Activation
  • Phosphoproteins
  • Percutaneous Coronary Intervention