Abstract 15344: Effect of Diabetes Mellitus and Chronic Kidney Disease on High On-Treatment Platelet Reactivity After Percutaneous Coronary Intervention
Background: Diabetes mellitus (DM) and chronic kidney disease (CKD) are associated with adverse clinical outcomes in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). High on-treatment platelet reactivity (HTPR) is also associated with a higher risk of cardiovascular event in these patients. But, there are limited data for effect of DM and CKD on HTPR.
Methods and Results: 1,590 (51.7%) patients measured platelet function with the VerifyNow P2Y12 test and not exposed to glycoprotein IIb/IIIa inhibitor from single center registry of 3,073 patients underwent PCI from 2009 to 2012 were analyzed. HTPR was defined as PRU value of ≥235. Patients were divided into four groups according to the presence of DM and CKD: without DM or CKD (n = 751); DM alone (n = 358); CKD alone (n = 287); and both CKD and DM (n = 194). The mean PRU values among these groups were 214.0 ± 90.4, 235.1 ± 93.6, 239.2 ± 99.6, and 264.0 ± 96.1, respectively (p < 0.001). The prevalence of HTPR was 41.3%, 57.7%, 53.5%, and 66.7%, respectively (p < 0.001). The incidence of a composite of any death, myocardial infarction, or repeated revascularization at 1-year of follow-up was 5.4%, 5.2%, 8.2%, and 18.1%, respectively (Log Rank p < 0.001). But, multivariate analysis revealed that only presence of DM alone [odd ratio (OR) 1.76, 95% confidence interval (CI): 1.30 - 2.38, p < 0.001] and hemoglobin level (OR 0.79, 95% CI: 0.72 - 0.86, p < 0.001) were independent predictors for HTPR.
Conclusion: Although presence of both DM and CKD was associated with higher prevalence of HTPR and worst adverse clinical outcome, presence of CKD alone was not an independent risk factor for HTPR.
- © 2013 by American Heart Association, Inc.