Combination of P2Y12 reaction unit and percentage of platelet inhibition assessed by VerifyNow P2Y12 assay is a useful predictor of long term clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
INTRODUCTION High on treatment platelet reactivity is a well known risk factor for adverse events in patients undergoing percutaneous coronary intervention (PCI) This study was to investigate the value of a novel platelet reactivity based system, named the COP INH (COmbination of P2Y12 reaction unit [PRU] and percentage of platelet inhibition %INH] assessed by VerifyNow P2Y12 assay, for predicting the long term ischaemic events in patients with acute coronary syndrome (ACS) undergoing PCI. MATERIALS AND METHODS The COP INH was calculated on the basis of data obtained at 30days after PCI: patients with both an elevated PRU =230) and decreased %INH <40% were allocated a score of 2, and patients showing one or neither were allocated a score of 1 or 0, respectively. The primary endpoint was the composite of cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization at 1year follow up. The relationship between the COP INH score and primary endpoint was analyzed. RESULTS 207 patients were enrolled. Baseline characteristics were similar between patients with COP INH=2 and patients with COP INH=1 or 0, except for diabetes mellitus (43.8% vs. 21.7% p=0.015) and previous coronary artery bypass grafting (CABG) (21.9% vs. 6.86% p=0.007) During the observation period, the incidence of major adverse cardiovascular events (MACE) in patients with COP INH=2 was significantly higher than patients with COP INH=1 or 0 (18.8% vs. 4.6% p=0.007) Multivariate analysis of clinical characteristics and platelet reactivity selected by univariate analysis showed that the COP INH=2 was an independent predictor of MACE in patients with ACS undergoing PCI (OR 2.745; 95% CI 1.369 9.851; p=0.024) whereas neither PRU>=230 nor %INH<40% was. CONCLUSION The COP INH is considered to be a useful predictor of long term ischaemic events of patients with ACS undergoing PCI.
Thrombosis research