Differences in high on-treatment platelet reactivity between intra-coronary and peripheral blood after dual anti-platelet agents in patients with coronary artery disease

作者：Hu Yu Feng; Lu Tse Min; Wu Cheng Hsueh; Lin Yenn Jiang; Chang Shih Lin; Lo Li Wei; Tuan Ta Chuan; Chao Tze Fan; Chung Fa Po; Liao Jo Nan; Tzeng Cheng Hwai; Chen Shih Ann^*; Tsao Hsuan Ming

来源：Thrombosis and Haemostasis, 2013, 110(1): 124-130.

DOI：10.1160/TH13-01-0034

• High on-treatment platelet reactivity
• aspirin
• clopidogrel
• coronary artery disease

The differences of high on-treatment platelet reactivity (HPR) between the coronary arteries and peripheral veins might be associated with poor prediction of adverse cardiovascular events in patients with coronary artery diseases. HPR from the peripheral blood might not ad, equately reflect the platelet responses in the coronary artery. A total of 21 patients were recruited, and regional differences in HPR were compared between blood samples from the intra-coronary artery (IC), femoral artery (FA), and femoral vein (FV) by light aggregometry (agonists: arachidonic acid, LTA-AA; ADP, LTA-ADP), Verify Now P2Y(12) assays, and a platelet function analyser (PFA-100, collagen and epinephrine cartridge, PFA-CEPI). There were regional differences in the platelet reactivities observed by LTA-AA, Verify Now P2Y(12) assays, and PFA-CEPI. Platelets from the IC had higher platelet reactivities than those from the FV and FA by the Verify Now P2Y(12) assays but lower reactivities by LTA-AA and PFA-CEPI. HPR values from the blood in the FA were more similar to those from the IC than those from the FV by any test. The monocyte percentages were the only factors associated with differences in HPR between the FV and IC by the VerifyNow P2Y(12) assays. Triglyceride levels were associated with the differences in HPR between the FV and IC by LTA-ADP. During the six-month follow-up period, two patients developed cardiovascular events and exhibited differences in HPR between different sites by VerifyNow P2Y(12) assays. In conclusions, there were regional differences in HPR in patients with coronary artery diseases, which might prevent the adequate prediction of cardiovascular events.

• 出版日期2013-7