Publication/Presentation Date

11-1-2016

Abstract

Background

The relationships between underweight status, platelet reactivity, and clinical outcomes after PCI with DES are not well understood.

Methods

ADAPT-DES was a prospective, multicenter study of 8582 pts treated with aspirin and clopidogrel in whom routine measurement of P2Y12 reaction units (PRU) by VerifyNow testing was performed following successful DES implantation. Pts were classified according to the following body mass index (BMI) groups: Underweight (BMI/m2), normal weight (20 kg/m2 ≤ BMI/m2), overweight (25 kg/m2 ≤ BMI/m2), and obese (BMI ≥30 kg/m2).

Results

Underweight pts were more often female, smokers, had higher rates of peripheral arterial disease and renal insufficiency, and more frequently presented with an acute coronary syndrome than those with higher BMI. Underweight pts had significantly lower PRU and lower rates of high on-treatment platelet reactivity (HPR), while obese pts had higher PRU and higher rates of HPR. Underweight pts had higher 2-year rates of clinically relevant bleeding and mortality compared to normal weight patients (Figure). By multivariable analysis, underweight status was independently associated with higher rates of bleeding compared to normal weight status (HR 1.88 [1.02-3.47], p=0.04), with a trend toward greater all-cause mortality (HR 2.18 [0.99-4.79], p=0.053).

Conclusion

In this large, prospective, observational study of DES-treated patients, underweight status was associated with lower PRU on clopidogrel and significantly higher rates of bleeding at 2 years.

Volume

68

Issue

18S

First Page

145

Last Page

145

ISSN

1558-3597

Disciplines

Cardiology | Medical Sciences | Medicine and Health Sciences

Department(s)

Department of Medicine, Cardiology Division, Department of Medicine Faculty

Document Type

Article

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