Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Pulmonary Vascular and General Medicine, Fuwai Yunnan Cardiovascular Hospital, Kunming, Yunnan Province, China.
J Int Med Res. 2022 Apr;50(4):3000605221081725. doi: 10.1177/03000605221081725.
To analyse the association between on-treatment platelet reactivity (TPR) and long-term outcomes of patients with acute coronary syndrome (ACS) and thrombocytopenia (TP) in the real world.
This prospective observational study enrolled patients with coronary artery disease (CAD) that underwent percutaneous coronary intervention (PCI). Patients with ACS and TP under dual antiplatelet therapy were selected for analysis. The 2- and 5-year clinical outcomes were evaluated among patients with high on-treatment platelet reactivity (HTPR), low on-treatment platelet reactivity (LTPR) and normal on-treatment platelet reactivity (NTPR), as tested by thromboelastogram at baseline.
A total of 10 724 patients with CAD that underwent PCI were identified. Of these, 474 patients with ACS and TP met the inclusion criteria: 124 (26.2%) with HTPR, 163 (34.4%) with LTPR and 187 (39.5%) with NTPR. The 5-year rates of all-cause death, major adverse cardiovascular and cerebrovascular events, cardiac death, myocardial infarction, revascularization, stroke and bleeding were not significantly different among the three groups. Multivariate Cox regression analysis demonstrated that patients with HTPR were not independently associated with any of the 5-year endpoints compared with patients with NTPR.
TPR at baseline was not independently associated with long-term outcomes in patients with ACS and TP that underwent PCI.
分析在真实世界中，急性冠状动脉综合征（ACS）和血小板减少症（TP）患者的治疗中血小板反应性（TPR）与长期结局之间的关系。
这项前瞻性观察性研究纳入了接受经皮冠状动脉介入治疗（PCI）的冠心病患者。选择接受双联抗血小板治疗的 ACS 和 TP 患者进行分析。通过基线血栓弹力图检测，评估高治疗中血小板反应性（HTPR）、低治疗中血小板反应性（LTPR）和正常治疗中血小板反应性（NTPR）患者的 2 年和 5 年临床结局。
共纳入 10724 例接受 PCI 的 CAD 患者，其中 474 例 ACS 和 TP 患者符合纳入标准：HTPR 患者 124 例（26.2%），LTPR 患者 163 例（34.4%），NTPR 患者 187 例（39.5%）。三组患者的全因死亡、主要心血管和脑血管不良事件、心脏死亡、心肌梗死、血运重建、卒中和出血的 5 年发生率无显著差异。多变量 Cox 回归分析表明，与 NTPR 患者相比，HTPR 患者与任何 5 年终点均无独立相关性。
PCI 治疗后的 ACS 和 TP 患者，基线 TPR 与长期结局无独立相关性。
