High Platelet Reactivity Associated with Adverse Events After Left Main Stenting

Patients undergoing PCI for unprotected LM lesions should routinely be tested for clopidogrel responsiveness.

Findings from multiple studies have demonstrated that high residual platelet reactivity (RPR) after clopidogrel loading is associated with adverse events, including stent thrombosis, after percutaneous coronary intervention. To examine this association in patients with unprotected left main (LM) coronary disease, investigators assessed platelet reactivity by light transmission aggregometry 12 to 18 hours after a 600-mg loading dose of clopidogrel in 215 patients undergoing PCI for unprotected LM lesions.

Forty patients (19%) had high RPR (platelet aggregation by adenosine diphosphate ≥70%). After PCI, most patients received aspirin (325 mg) and clopidogrel (75 mg) daily for at least 12 months. However, patients with high RPR received alterna…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI