Author + information
To evaluate the associationbetween mean platelet aggregation degree and long-term clinical outcomes inpatients receiving complex percutaneous coronary intervention (CPCI).
We screened 2,141 patientsafter PCI and treated with aspirin and clopidogrel. CPCI was defined as aprocedure targeted to at least one of the following: left main disease;bifurcation lesion; ostial lesion; chronic total occlusion and small vesselstenting. Adenosine diphosphate (ADP) -induced platelet aggregation was requiredto be serially measured by light transmission aggregometry at least three timesafter PCI and the mean value was calculated. The population was categorized accordingto the mean ADP degree and presence of CPCI. The primary endpoint was majoradverse cardiovascular and cerebral event (MACCE).
Finally, a total of 1,245patients were enrolled and divided into four groups: Group A (CPCI &ADP≥40%), Group B (CPCI & ADP<40%), Group C (non-CPCI & ADP≥40%) andGroup D (non-CPCI & ADP<40%). The median follow-up was 29.9 months. The Cox multivariate analysis suggested that Group A was anindependent risk factor of MACCE (HR 2.70, 95%CI 1.25-5.81; P<0.001). Comparedwith Group A, Group B, C and D were all associated with a lower rate of MACCE. WhenGroup C set as a comparator, Group B and Group D had similar risk of primaryendpoints.
Patients undergoing CPCI withhigh mean ADP degree were associated with higher risk of MACCE. Serial PFT isof importance in patients receiving CPCI.