Τίτλος:
The prognostic value of multiple electrode aggregometry and light transmittance aggregometry in stable cardiovascular patients with type 2 diabetes mellitus
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim: Limited data are available regarding the clinical relevance of platelet function measurements in stable patients with coronary artery disease (CAD). Our aim is to evaluate the agreement between multiple electrode aggregometry (MEA) and light transmittance aggregometry (LTA) in detecting clopidogrel low responders and their prognostic value in CAD patients with type 2 diabetes mellitus (T2DM) on dual platelet inhibition. Methods: LTA and MEA were performed in 122 stable cardiovascular patients with T2DM. The upper quartile of patients according to maximum LTA (LTAmax) and MEA measurements were defined as clopidogrel low responders. Agreement between the two methods was evaluated by kappa statistics. We assessed the potential correlation between antiplatelet response and clinical outcome and the optimal cutoff value according to ROC analysis to predict the occurrence of major adverse cardiovascular events (MACE), during 1-year follow-up period. Results: Cohen's kappa coefficients (0.214) indicated fair agreement (70.2%) between LTA and MEA. A total of 25 MACE occurred in 108 patients (23.1%). Patients with MACE had higher LTAmax than those without (57.1 ± 16.5 vs 49.3 ± 18.3, respectively, p = 0.023). MEA measurements were similar between patients with and without MACE (30.1 ± 15.4 vs 30.6 ± 20.8, respectively; p = 0.84). Multiple logistic regression showed LTAmax response as an independent predictor of death from cardiovascular causes (Odds Ratio, adjusted:0.2;0.05–0.81). ROC analysis indicated that LTAmax cutoff of 62.5% best predicted death (AUC = 0.67, sensitivity = 78%, specificity = 61.5%). Conclusions: The assessment of platelet responsiveness remains highly test-specific. Our results support the prognostic role of LTA, but not MEA testing, for death risk evaluation in stable cardiovascular T2DM patients. © 2019 Elsevier Ltd
Συγγραφείς:
Tsantes, A.Ε.
Taichert, M.
Kyriakou, E.
Katogiannis, K.
Lytras, T.
Gialeraki, A.
Tzoumakidou, E.
Kokoris, S.
Douramani, P.
Kypraiou, A.
Poulis, A.
Katsadiotis, G.
Kalantzis, D.
Kottaridi, C.
Kopterides, P.
Bonovas, S.
Ikonomidis, I.
Περιοδικό:
Thrombosis Research
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
acenocoumarol; acetylsalicylic acid; antidiabetic agent; apixaban; beta adrenergic receptor blocking agent; calcium channel blocking agent; clopidogrel; dabigatran; hydroxymethylglutaryl coenzyme A reductase inhibitor; insulin; proton pump inhibitor; rivaroxaban, adult; aged; Article; cardiovascular disease; cardiovascular mortality; cause of death; clinical outcome; comorbidity; controlled study; coronary artery disease; correlation analysis; diagnostic test accuracy study; drug response; female; follow up; human; human cell; intermethod comparison; light transmittance aggregometry; major clinical study; male; middle aged; mortality risk; multiple electrode aggregometry; non insulin dependent diabetes mellitus; platelet aggregation assay; prediction; priority journal; prognosis; receiver operating characteristic; sensitivity and specificity; thromboembolism; very elderly; blood; blood clotting parameters; complication; coronary artery disease; devices; non insulin dependent diabetes mellitus; prognosis; thrombocyte aggregation, Aged; Coronary Artery Disease; Diabetes Mellitus, Type 2; Female; Humans; Male; Middle Aged; Platelet Aggregation; Platelet Function Tests; Prognosis
DOI:
10.1016/j.thromres.2019.06.001
