Author + information
- Monica Verdoia,
- Veronica Daffara,
- Paolo Marino and
- Giuseppe De Luca
Background: Vitamin D Binding Protein (VDBP) is the main transporter of vitamin D in the bloodstream and genetic polymorphisms of this protein have been shown to account for a significant variability of vitamin D levels. Contrasting data have linked the rs7041 T to G substitution with cardiovascular disease. However, no study has so far addressed the role of rs7041 polymorphism on platelet reactivity in patients on DAPT, that was the aim of the present study.
Methods: Patients on DAPT (ASA +clopidogrel or ticagrelor) for an ACS or elective PCI were scheduled for platelet function assessment at 30-90 days post-discharge. Platelet function was assessed by Multiplate® (Roche Diagnostics AG), and VDBP genetic status by polymerase chain reaction and restriction fragment length polymorphism technique.
Results: We included 400 patients, 187 (46.8%) on clopidogrel and 213 (53.2%) ticagrelor. The genetic polymorphism rs7041 (T to G) was observed in 318 patients, (79.5%), in 38.7% of them in homozygosis. Main clinical and chemistry features did not significantly differ according to genetic status, but for a higher rate of ACE-inhibitors and beta-blockers use among the carriers of the G allele (p=0.04 and p=0.01, respectively). VDBP genetic status did not affect the rate of HRPR with ADP-antagonists (25.6% vs 24.6% vs 28.5%, p=0.59; adjusted OR[95%CI]= 0.94[0.52-1.7], p=0.83 for T/G patients; adjusted OR[95%CI]= 1.14[0.6-2.2], p=0.67 for G homozygotes). However, the rate of HRPR with ADP-antagonists was influenced by severe hypovitaminosis D (<10 ng/ml) only in patients carrying the G allele, especially in homozygosis (T/T: 25.9%vs 26.1%, p=0.99; T/G+G/G: 22.1% vs 35.3%, p=0.02, pinteraction=0.019; adjusted OR[95%CI]=1.93[1.11-3.34], p=0.02 for G arriers).
Conclusions: The present study shows that rs7041 polymorphism of Vitamin D Binding Protein does not affect platelet reactivity or the rate of HRPR among patients receiving DAPT. However the carriage of the G allele conditions the impact of hypovitaminosis D on the response to antiplatelet agents, with an increased occurrence of HRPR especially in homozygotes, where vitamin D deficiency could play a more relevant role.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Antithrombotic Therapy in Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1252-315
- 2017 American College of Cardiology Foundation