High on-treatment platelet reactivity and outcomes after percutaneous endovascular procedures in patients with peripheral artery disease

Isabell Bernlochner, Juliane Jaitner, Verena Fries, Michael Dommasch, Katharina Mayer, Ilka Ott, Nicolas Langwieser, Massimiliano Fusaro, Karl Ludwig Laugwitz, Adnan Kastrati, Tareq Ibrahim

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: High on-treatment platelet reactivity (HPR) predicts adverse cardiovascular events in patients with coronary artery disease. The impact of HPR in patients with peripheral artery disease (PAD) after peripheral endovascular procedures is unclear. Patients and methods: A total of 385 patients with PAD and successful percutaneous endovascular procedure were included. Patients received aspirin as a long-term treatment in addition to the P2Y12 receptor antagonist clopidogrel, as recommended after such a procedure for at least 1 month. Platelet function was assessed on a Multiplate analyzer. The primary endpoint was target lesion revascularization (TLR) at one year. Restenosis (≥ 75 %) in duplex sonography, mortality at one year and identification of independent predictors of TLR were secondary endpoints. Results: TLR rates were similar in HPR and no-HPR patients (14.3 % vs. 12.7 %, hazard rate (HR) 0.94, 95 % CI 0.48 - 1.84, P = 0.86). Restenosis (≥ 75 %) in duplex sonography did not differ between the two study groups (15.6 % vs. 16.9 %, HR 1.16, 95% CI 0.62 - 2.12, P = 0.64). Independent predictors of TLR were intervention of restenotic lesions, total vessel occlusions and critical limb ischemia, but not HPR (adjusted HR 1.07, 95% CI 0.55 - 2.10, P = 0.84). No difference in mortality at one year was observed (1.3 % vs. 1.6 %, HR 1.28, 95 % CI 0.15 - 11.0, P = 0.82). Conclusions: In patients with PAD, HPR did not have a significant impact on outcomes within the first year after percutaneous endovascular intervention.

Original languageEnglish
Pages (from-to)155-161
Number of pages7
JournalVasa - European Journal of Vascular Medicine
Volume45
Issue number2
DOIs
StatePublished - Apr 2016

Keywords

  • High platelet reactivity
  • Outcomes
  • Peripheral artery disease
  • Restenosis
  • Target lesion revascularization

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