Effects of persistent platelet reactivity despite aspirin therapy on cardiac troponin I and creatine kinase-MB levels after elective percutaneous coronary interventions.

Abstract

BACKGROUND:

Creatinine kinase-MB (CK-MB) and cardiac troponin I (cTnI) elevations are highly specific for myonecrosis after percutaneous coronary intervention (PCI). Aspirin is used to prevent thrombotic complications. Several studies have shown that some individuals exhibit a reduced or completely missing antiplatelet response to aspirin. The aim of this study is to investigate the effects of platelet reactivity despite aspirin therapy on CK-MB and cTnI levels after elective percutaneous coronary interventions despite 600 mg loading dose of clopidogrel.

METHODS:

One hundred fourteen (mean age 61.2+/-9.3 years, 78.1% male) patients receiving 300 mg daily enteric coated aspirin for at least 7 days with documented coronary artery disease were included in the study. Platelet reactivity despite aspirin was measured by platelet function analyzer (PFA)-100 collagen/epinephrine cartridge. Blood samples for CK-MB and cTnI were obtained before and at 6, 24, and 36 h after the PCI. Persistent platelet reactivity was defined when collagen/epinephrine closure time<165 s.

RESULTS:

A total of 87 (76.4%) patients were noted to have normal platelet reactivity (Group A), and 27 (23.6%) had persistent platelet reactivity (Group B). The elevations of CK-MB and cTnI levels were statistically significant within the groups (both P<0.001). However, there were no significant differences in the CK-MB and cTnI levels of the groups at baseline and after PCI for all studied hours.

CONCLUSION:

Persistent platelet reactivity was not associated with increased risk of CK-MB, cTnI elevations in low-to-intermediate risk PCI patients.

• Authors: Oyku Gulmez, Aylin Yildirir, Gamze Kaynar, Didem Konas, Alp Aydinalp, Cagatay Ertan, Bulent Ozin, Haldun Muderrisoglu
• Journal: Journal of thrombosis and thrombolysis (J Thromb Thrombolysis) Vol. 25 Issue 3 Pg. 239-46 (Jun 2008) ISSN: 0929-5305 [Print] Netherlands
• PMID: 17574519 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Biomarkers
• Platelet Aggregation Inhibitors
• Tablets, Enteric-Coated
• Troponin I
• Clopidogrel
• Creatine Kinase, MB Form
• Ticlopidine
• Aspirin

Topics

• Aged
• Angioplasty, Balloon, Coronary (adverse effects)
• Aspirin (therapeutic use)
• Biomarkers (blood)
• Clopidogrel
• Coronary Artery Disease (blood, therapy)
• Creatine Kinase, MB Form (blood)
• Drug Resistance
• Female
• Humans
• Male
• Middle Aged
• Myocardium (enzymology, pathology)
• Necrosis
• Platelet Activation (drug effects)
• Platelet Aggregation Inhibitors (therapeutic use)
• Platelet Function Tests
• Tablets, Enteric-Coated
• Thrombosis (blood, etiology, prevention & control)
• Ticlopidine (analogs & derivatives, therapeutic use)
• Time Factors
• Troponin I (blood)
• Up-Regulation