Sex Differences in the Clinical Impact of High Platelet Reactivity After Percutaneous Coronary Intervention With Drug-Eluting Stents: Results From the ADAPT-DES Study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents).
Publication/Presentation Date
2-1-2017
Abstract
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown.
METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208). Study end points were definite and probable stent thrombosis (ST), clinically relevant bleeding, all-cause mortality, myocardial infarction, and major adverse cardiac events (comprising mortality, myocardial infarction, and target lesion revascularization). HPR was more common among women (1118/2163, 51.7%) than men (2491/6285, 39.6%). HPR was associated with a roughly double risk of 1-year ST in both women and men (women with versus without HPR: 1.4% versus 0.7%; hazard ratio [HR], 2.02; 95% confidence interval [CI], 0.82-4.95;
CONCLUSIONS: In the current analysis, the associated risk of HPR for ST was similar in both sexes. However, HPR was associated with significantly reduced bleeding only among women.
CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00638794.
Volume
10
Issue
2
ISSN
1941-7632
Published In/Presented At
Yu, J., Mehran, R., Baber, U., Ooi, S. Y., Witzenbichler, B., Weisz, G., Rinaldi, M. J., Neumann, F. J., Metzger, D. C., Henry, T. D., Cox, D. A., Duffy, P. L., Mazzaferri, E. L., Jr, Brodie, B. R., Stuckey, T. D., Maehara, A., Xu, K., Ben-Yehuda, O., Kirtane, A. J., & Stone, G. W. (2017). Sex Differences in the Clinical Impact of High Platelet Reactivity After Percutaneous Coronary Intervention With Drug-Eluting Stents: Results From the ADAPT-DES Study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents). Circulation. Cardiovascular interventions, 10(2), e003577. https://doi.org/10.1161/CIRCINTERVENTIONS.116.003577
Disciplines
Cardiology
PubMedID
28193677
Department(s)
Cardiology Division
Document Type
Article
