Abstract 19023: Is there a Correlation Between Bleeding Risk Score and Platelet Aggregability?
Background: Clinically relevant bleeding in ACS patients is strongly associated with mortality, with an HR similar to that of stent thrombosis. Although recent data have suggested that on-treatment platelet reactivity after PCI is an independent predictor of bleeding events, this correlation is not as clearly established as for HPR and stent thrombosis, with very few conflicting publications in the literature. The main objective of the present analysis was to evaluate the relationship between platelet reactivity and bleeding risk score in ACS patients submitted to PCI.
Methods: In a prospective way, we assessed platelet aggregability using VerifyNow P2Y12® assay from 131 ACS patients submitted to PCI, at their discharge from the Coronary Care Unit. All patients were on DAPT with aspirin 100mg + clopidogrel 75mg daily. Low platelet reactivity (LPR) was defined as VerifyNow <85 P2Y12 Reaction Units (PRU). The ACUITY/HORIZONS-AMI bleeding risk score was used to assess the population’s bleeding risk.
Results: The mean age of the population was 64 years. Low platelet reactivity was observed in 25 patients (19%). There was no significant difference between LPR and no-LPR groups in relation to the mean bleeding risk score (14,6±7,7 PRU vs 15,3±6,9 PRU respectively, p=0.453). By linear regression, a very poor correlation was detected between VerifyNow P2Y12® values and bleeding score risk values (figure 1). By multivariable analysis, only hypertension (OR 0,23; 95% CI 0.093 to 0.73, p=0.01) and previous PCI (OR 2,9; 95% CI 1.05 to 8,2, p=0.04) correlated independently with LPR.
Conclusion: In post-PCI ACS patients, there is no correlation between platelet aggregability and bleeding risk score. Although the latter is an important toll to minimize bleeding complications, more data is necessary to assess the role of platelet aggregability in the decision making process of this population.
Author Disclosures: F.B. Arantes: None. R.H. Furtado: None. C.J. Barbosa: None. A. Franci: None. F.R. Menezes: None. T.D. Falcao: None. C.A. Nakashima: None. L.M. Baracioli: None. J.A. Ramires: None. J.C. Nicolau: None.
- © 2014 by American Heart Association, Inc.