Long Term Cardiovascular Outcome Based on Aspirin and Clopidogrel Responsiveness Status in Young ST-Elevated Myocardial Infarction Patients

Background: A subset of patients who take antiplatelet therapy continues to have recurrent cardiovascular events which may be due to antiplatelet resistance. The effect of low response to aspirin or clopidogrel on prognosis was examined in different patient populations. Objective: We aimed to investigate the prevalence of poor response to dual antiplatelet therapy and its relationship with major adverse cardiovascular events (MACE) in young patients with ST-elevation myocardial infarction (STEMI). Methods: In our study, we included 123 patients under the age of 45 with STEMI who underwent primary percutaneous intervention. A screening procedure to determine both aspirin and clopidogrel responsiveness was performed on the fifth day of admission. We followed a 2x2 factorial design and patients were allocated to one of four groups, according to the presence of aspirin and/or clopidogrel resistance. Patients were followed for a three-year period. A p-value less than 0.05 was considered statistically significant. Results: We identified 48% of resistance against one or more antiplatelet in young patients with STEMI. More MACE was observed in patients with poor response to dual platelet therapy or to clopidogrel compared those with adequate response to the dual therapy (OR: 1.875, 1.144-3.073, p < 0.001; OR: 1.198, 0.957-1.499, p = 0.036, respectively). After adjustment for potential confounders, we found that poor responders to dual therapy had 3.3 times increased odds for three-year MACE than those with adequate response to the dual therapy. Conclusion: Attention should be paid to dual antiplatelet therapy in terms of increased risk for cardiovascular adverse events especially in young patients with STEMI.

Yazar Somuncu, Mustafa Umut
Demir, Ali Riza
Karakurt, Seda Tukenmez
Karakurt, Huseyin
Karabag, Turgut
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/2893
Tek Biçim Adres 10.5935/abc.20180251
Konu Başlıkları Acute Coronary Syndrome
Aspirin/adverse effects
Platelet Aggregation
Young Adult
ST Elevation Myocardial Infarction
Mortality
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı ARQUIVOS BRASILEIROS DE CARDIOLOGIA
Dergi Cilt Bilgisi 112
Dergi Sayısı 2
Sayfalar 138 - 145
Yayın Yılı 2019
Eser Adı
[dc.title]
Long Term Cardiovascular Outcome Based on Aspirin and Clopidogrel Responsiveness Status in Young ST-Elevated Myocardial Infarction Patients
Yazar
[dc.contributor.author]
Somuncu, Mustafa Umut
Yazar
[dc.contributor.author]
Demir, Ali Riza
Yazar
[dc.contributor.author]
Karakurt, Seda Tukenmez
Yazar
[dc.contributor.author]
Karakurt, Huseyin
Yazar
[dc.contributor.author]
Karabag, Turgut
Yayın Yılı
[dc.date.issued]
2019
Yayıncı
[dc.publisher]
ARQUIVOS BRASILEIROS CARDIOLOGIA
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Background: A subset of patients who take antiplatelet therapy continues to have recurrent cardiovascular events which may be due to antiplatelet resistance. The effect of low response to aspirin or clopidogrel on prognosis was examined in different patient populations. Objective: We aimed to investigate the prevalence of poor response to dual antiplatelet therapy and its relationship with major adverse cardiovascular events (MACE) in young patients with ST-elevation myocardial infarction (STEMI). Methods: In our study, we included 123 patients under the age of 45 with STEMI who underwent primary percutaneous intervention. A screening procedure to determine both aspirin and clopidogrel responsiveness was performed on the fifth day of admission. We followed a 2x2 factorial design and patients were allocated to one of four groups, according to the presence of aspirin and/or clopidogrel resistance. Patients were followed for a three-year period. A p-value less than 0.05 was considered statistically significant. Results: We identified 48% of resistance against one or more antiplatelet in young patients with STEMI. More MACE was observed in patients with poor response to dual platelet therapy or to clopidogrel compared those with adequate response to the dual therapy (OR: 1.875, 1.144-3.073, p < 0.001; OR: 1.198, 0.957-1.499, p = 0.036, respectively). After adjustment for potential confounders, we found that poor responders to dual therapy had 3.3 times increased odds for three-year MACE than those with adequate response to the dual therapy. Conclusion: Attention should be paid to dual antiplatelet therapy in terms of increased risk for cardiovascular adverse events especially in young patients with STEMI.
Açıklama
[dc.description]
WOS: 000458635000006
Açıklama
[dc.description]
PubMed: 30570067
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
Acute Coronary Syndrome
Konu Başlıkları
[dc.subject]
Aspirin/adverse effects
Konu Başlıkları
[dc.subject]
Platelet Aggregation
Konu Başlıkları
[dc.subject]
Young Adult
Konu Başlıkları
[dc.subject]
ST Elevation Myocardial Infarction
Konu Başlıkları
[dc.subject]
Mortality
Haklar
[dc.rights]
info:eu-repo/semantics/openAccess
ISSN
[dc.identifier.issn]
0066-782X
İlk Sayfa Sayısı
[dc.identifier.startpage]
138
Son Sayfa Sayısı
[dc.identifier.endpage]
145
Dergi Adı
[dc.relation.journal]
ARQUIVOS BRASILEIROS DE CARDIOLOGIA
Dergi Sayısı
[dc.identifier.issue]
2
Dergi Cilt Bilgisi
[dc.identifier.volume]
112
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.5935/abc.20180251
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/2893
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
11
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
05 Şubat 2024 20:54
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Tıklayınız
patients therapy antiplatelet response clopidogrel events aspirin resistance cardiovascular adverse three-year adequate increased followed period compared platelet observed significant against p-value considered identified statistically Results Background especially should Attention Conclusion responders confounders potential adjustment respectively)
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