Dataset Information

Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study.

ABSTRACT:

Background

The clinical and prognostic implications of platelet reactivity (PR) testing in a P2Y₁₂-inhibitor naïve population are poorly understood.

Objectives

This explorative study aims to assess the role of PR and explore factors that may modify elevated mortality risk in patients with altered PR.

Methods

Platelet ADP-induced CD62P and CD63 expression were measured by flow-cytometry in 1520 patients who were referred for coronary angiography in the Ludwigshafen Risk and Cardiovascular Health Study (LURIC).

Results

High- and Low-platelet reactivity to ADP were strong predictors of cardiovascular and all-cause mortality and risk equivalent to the presence of coronary artery disease. (High platelet reactivity 1.4 [95% CI 1.1-1.9]; Low platelet reactivity: 1.4 [95% CI 1.0-2.0]). Relative weight analysis indicated glucose control (HbA1c), renal function ([eGFR]), inflammation (high-sensitive C-reactive protein [hsCRP]) and antiplatelet therapy by Aspirin as consistent mortality risk modifiers in patients with Low- and High-platelet reactivity. Pre-specified stratification of patients by risk modifiers HbA1c (<7.0%), eGFR (>60 mL/min/1.73 m²) and CRP (<3 mg/L) was associated with a lower mortality risk, however irrespective of platelet reactivity. Aspirin treatment was associated with reduced mortality in patients with high platelet reactivity only (p for interaction: 0.02 for CV-death [<0.01 for all-cause mortality].

Conclusions

Cardiovascular mortality risk in patients with High- and Low platelet reactivity is equivalent to the presence of coronary artery disease. Targeted glucose control, improved kidney function and lower inflammation are associated with reduced mortality risk, however independent of platelet reactivity. In contrast, only in patients with High-platelet reactivity was Aspirin treatment associated with lower mortality.

SUBMITTER: Berger M

PROVIDER: S-EPMC10003439 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study.

Berger Martin M Dressel Alexander A Kleber Marcus E ME März Winfried W Hellstern Peter P Marx Nikolaus N Schütt Katharina K

Journal of clinical medicine 20230228 5

<h4>Background</h4>The clinical and prognostic implications of platelet reactivity (PR) testing in a P2Y<sub>12</sub>-inhibitor naïve population are poorly understood.<h4>Objectives</h4>This explorative study aims to assess the role of PR and explore factors that may modify elevated mortality risk in patients with altered PR.<h4>Methods</h4>Platelet ADP-induced CD62P and CD63 expression were measured by flow-cytometry in 1520 patients who were referred for coronary angiography in the Ludwigshafe ...[more]

PMID: 36902699

Similar Datasets

Project description:IntroductionNeutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein released by damaged renal tubular cells and mature neutrophils. It is elevated in kidney injury, but also in patients with coronary artery disease (CAD) and myocardial infarction. We investigated the prognostic value of NGAL for total and cardiovascular mortality in patients undergoing coronary angiography without history of renal insufficiency at inclusion into the study.ParticipantsThe LURIC study is an ongoing prospective cohort study of patients referred for coronary angiography and is designed to evaluate determinants of cardiovascular health.ResultsNGAL was determined in plasma of 2997 persons (mean age: 62.7 years; 69.7% men) with a follow up for 10 years. 2358 patients suffered from CAD and 638 did not-these patients served as controls. Stable CAD was found in 1408 and unstable CAD in 950 patients. Death rate from cardiovascular events and all causes was highest in patients within the 4th quartile of NGAL (≥56 ng/ml, p<0.001 vs third quartile), even after adjustment for age and gender. According to multivariable-adjusted Cox analysis adjusting for well-known cardiovascular risk factors, as well as lipid lowering therapy, angiographic CAD, and C-reactive protein we found patients in the highest NGAL quartile being at increased risk for cardiovascular (hazard ratio (HR) 1.33, 95%CI 1.05-1.67, p = 0.016) and all cause mortality (HR 1.29 95%CI 1.07-1.55, p = 0.007) compared to those in the third quartile. The lowest risk was seen in the third quartile of NGAL (41-56 ng/ml) suggesting a U-shaped relationship between NGAL and mortality. Further adjustment for creatinine abrogated the predictive effect of NGAL. However, the 3rd and 4th quartiles of NGAL were significantly associated with higher neutrophil counts, which were associated with CAD, non-ST elevation and ST-elevation myocardial infarction (p<0.05).ConclusionsPlasma NGAL concentrations are mainly derived from neutrophils and do not predict mortality independent of renal function.

Dataset Information

Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study.

Background

Objectives

Methods

Results

Conclusions

Publications

Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study.

Similar Datasets

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